[Hemorrhagic colitis and hemolytic-uremic syndrome--E. coli as the etiologic agent. I. Bacteriology and pathogenesis].

Since 1983 when the connection between haemorrhagic colitis (HC), haemolytic uraemic syndrome (HUS), and intestinal infections by verotoxin-producing E. coli (VTEC, EHEC) was demonstrated, a lot of arguments has been accumulated showing verotoxins (Shiga-like toxins, SLT) and adhesive fimbria to play a key role in the pathogenicity of the respective E. coli group. The toxins bind via Gb3 receptors to the target cells and after internalization inhibit the protein synthesis. Due to the particular clustering of receptors at cell surfaces, vascular endothelial cells, intestinal epithelial cells as well as kidney and nerve tissues are especially affected. The severity of illness is obviously dependent on the relation between release of toxins and the actual level of anti-toxin-IgG in the blood.