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Abstract
Gastrointestinal infection with verotoxin-producing Escherichia coli (VTEC) has been
strongly implicated in the etiology of the hemolytic uremic syndrome (HUS), the leading
cause of pediatric acute renal failure. The binding of fluorescein-conjugated VT1
overlaid on to frozen human renal sections has been examined. Sections from biopsies
of infants aged < 2 years were compared with those from adult autopsies. VT primarily
stained distal convoluted tubules, particularly those adjacent to glomeruli, and collecting
ducts. VT-binding was detected within the infant glomerulus but not the adult. Binding
of the toxin was removed when the section was pretreated with α-galactosidase, confirming
the receptor-binding specificity for globotriaosyl ceramide (galα1-4galβ1-4 glucosyl-ceramide),
the glycolipid receptor for VT. These studies may suggest that differential localization
of this glycolipid in the pediatric renal glomerulus is a risk factor for the development
of HUS following infection with VTEC.