RTX-family toxin EhxA drives morphological remodeling and thrombogenesis in RBCs during enterohemorrhagic <i>Escherichia coli</i> infection.

ABSTRACT: Enterohemorrhagic Escherichia coli (EHEC) causes thrombotic microangiopathy, yet the red blood cell (RBC)-centered mechanism has remained unclear. We identify the RTX-family hemolysin EhxA as the driver of RBC-mediated thrombogenesis. Deletion of ehxA abolishes Ca²⁺ influx, phosphatidylserine (PS) exposure, progression from discocyte to echinocyte to spherocyte, thrombin generation, RBC-endothelium adhesion, and RBC aggregation. Genetic complementation restores these readouts to wild type, and purified EhxA in bacteria-free assays recapitulates them while localizing to intact RBC membranes. By contrast, Δstx2 mutants do not elicit these RBC phenotypes, distinguishing this pathway from Shiga toxin-dependent effects. Multiple regression quantifies the link bet

SUBMITTER: Choi S 

PROVIDER: S-EPMC12880542 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature