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STEC possess a number of virulence factors, but Shiga toxins (Stxs) were considered the most critical in disease pathogenesis and are responsible for hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS). Stxs are
AB5 holotoxins and are comprised of one A subunit (32 kDa) and five B subunits (7.7 kDa). The Stx A subunit is an enzymatically active N-glycosidase that inhibits the activity of rRNA by cleavage of an adenine base from the 28S rRNA component of the eukaryotic ribosomal 60S subunit, causing protein synthesis to cease resulting in cell death. The Stx B subunit is responsible for binding to host cells through interaction with globotriaosylceramide (Gb3) or globotetraosylceramide (Gb4) receptors present on the surfaces of cells, leading to subsequent internalization of the toxin.