The pathogenesis of Shigella diarrhea. VI. Toxin and antitoxin in Shigella flexneri and Shigella sonnei infections in humans.

Two strains of Shigella flexneri and one of Shigella sonnei were studied for toxin production in vitro. All of the three strains produced a cell-free cytotoxin that showed marked similarity to that produced by Shigella dysenteriae 1. Each toxin eluted in two distinct peaks on chromatography with Sephadex G-150, was destroyed by heating at 90 C for 30 min, and was neutralized by S. dysenteriae 1 antitoxin. Patients with infections due to S. flexneri and S. sonnei developed antibody that neutralized S. dysenteriae 1 toxin in vitro. In three of seven positive sera studied by sucrose density-gradient ultracentrifugation, antibody activity was associated only with the IgM fraction. The time course of the antibody response resembled that found in infections due to S. dysenteriae 1, in which an IgM antitoxin antibody has also been described. Since three species of Shigella have now been shown to be toxigenic, it is possible that bacterial toxin may play a role, along with bacterial invasion, in the pathogenesis of infections due to S. flexneri and S. sonnei, as well as those due to S. dysenteriae 1.