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Considered the main predictor of death, STEC encephalopathy plays a critical role in hemolytic uremic syndrome (HUS), which affects between 11% and 64% of HUS patients and considerably increases the risk of morbidity and mortality. Of note, STEC encephalopathy in the absence of HUS has been observed in approximately 5% of cases. The ability of enterohemorrhagic\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    to adapt to its microenvironment has been responsible for global outbreaks. Once in circulation, Shiga toxin rapidly induces endothelial damage via the Gb3 receptor. Brain inflammation in STEC encephalopathies has been consistently reported and experimentally confirmed. The entry of Shiga toxin into the brain leads to direct neuronal damage through its interaction with neuronal Gb3, as demonstrated in clinical case studies and experimental models. This review also discusses the adverse effects of STEC on the brain, which may arise from metabolic or circulatory disruptions, secondary damage to the CNS, or a multifactorial combination. Recent studies have highlighted the significance of neuroimaging techniques in diagnosing HUS encephalopathy. Efforts have been made to identify early neural biomarkers and develop corresponding treatments. Although various biomarkers have been reported, additional studies are needed for further development and standardization. Late-stage pharmacological treatments for encephalopathy are also discussed, both in clinical settings and experimental research.\n                  <\/jats:p>","DOI":"10.1128\/mmbr.00301-25","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T14:00:53Z","timestamp":1767621653000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Deleterious consequences of Shiga toxin in the CNS"],"prefix":"10.1128","volume":"90","author":[{"given":"Ana Bel\u00e9n","family":"Ramos-Aloi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0081fs513","id-type":"ROR","asserted-by":"publisher"}],"name":"Consejo Nacional de Investigaciones Cient\u00edficas y T\u00e9cnicas (CONICET), Laboratorio de Neurofisiopatolog\u00eda, Facultad de Medicina, Universidad de Buenos Aires, Instituto de Fisiolog\u00eda y Biof\u00edsica \u201cHoussay\u201d (IFIBIO)","place":["Ciudad de Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Soledad","family":"Arias","sequence":"additional","affiliation":[{"name":"Laboratorio de Bacteriolog\u00eda General, Instituto de Patobiolog\u00eda Veterinaria, Instituto Nacional de Tecnolog\u00eda Agropecuaria-Consejo Nacional de Investigaciones Cient\u00edficas y Tecnol\u00f3gicas (IPVet), INTA-CONICET","place":["William C. 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