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Infection and Immunity, August 2005, p. 4607-4613, Vol. 73, No. 8
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.8.4607-4613.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Human Antibody against Shiga Toxin 2 Administered to Piglets after the Onset of Diarrhea Due to Escherichia coli O157:H7 Prevents Fatal Systemic Complications

Abhineet S. Sheoran,1 Susan Chapman-Bonofiglio,1 Barrett R. Harvey,2 Jean Mukherjee,1 George Georgiou,2 Arthur Donohue-Rolfe,1 and Saul Tzipori1*

Division of Infectious Diseases, Tufts University School of Veterinary Medicine, 200 Westboro Rd., Building 20, North Grafton, Massachusetts 01536,1 Institute of Cellular and Molecular Biology, University of Texas, Austin, Texas 787122

Received 9 December 2004/ Returned for modification 17 January 2005/ Accepted 22 March 2005

Infection of children with Shiga toxin (Stx)-producing Escherichia coli (STEC) can lead to hemolytic-uremic syndrome (HUS) in 5 to 10% of patients. Stx2, one of two toxins liberated by the bacterium, is directly linked with HUS. We have previously shown that Stx-specific human monoclonal antibodies protect STEC-infected animals from fatal systemic complications. The present study defines the protective antibody dose in relation to the time of treatment after the onset of diarrhea in infected gnotobiotic piglets. Using the mouse toxicity model, we selected 5C12, an antibody specific for the A subunit, as the most effective Stx2 antibody for further characterization in the piglet model in which piglets developed diarrhea 16 to 40 h after bacterial challenge, followed by fatal neurological symptoms at 48 to 96 h. Seven groups of piglets received doses of 5C12 ranging from 6.0 mg/kg to 0.05 mg/kg of body weight, administered parenterally 48 h after bacterial challenge. The minimum fully protective antibody dose was 0.4 mg/kg, and the corresponding serum antibody concentration in these piglets was 0.7 µg (±0.5)/ml, measured 7 to 14 days after administration. Of 40 infected animals which received Stx2 antibody treatment of ≥0.4 mg/kg, 34 (85%) survived, while only 1 (2.5%) of 39 placebo-treated animals survived. We conclude that the administration of the Stx2-specific antibody was protective against fatal systemic complications even when it was administered well after the onset of diarrhea. These findings suggest that children treated with this antibody, even after the onset of bloody diarrhea, may be equally protected against the risk of developing HUS.

* Corresponding author. Mailing address: Tufts University School of Veterinary Medicine, Division of Infectious Diseases, 200 Westboro Rd., Building 20, North Grafton, MA 01536. Phone: (508) 839-7955. Fax: (508) 839-7911. E-mail: saul.tzipori{at}tufts.edu.

Editor: J. D. Clements

Infection and Immunity, August 2005, p. 4607-4613, Vol. 73, No. 8
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.8.4607-4613.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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