Moon et al. (2005) observed that during the development of HUS, TNFα and IL-1 expressions are induced by Stx in association with LPS, damaging endothelial and intestinal epithelial cells. In vitro studies performed on human HT29 colon epithelial cells have shown that TNFα increases the synthesis of Gb3 through GCS, and upregulates Beta4Gal-T5 and Gb3 through NF-kappaB signaling in mitogen-activated protein kinase (p38, JNK 1/2 and ERK 1/2)-induced cascades (Moon et al., 2005). Here, TNF is linked to hemolytic-uremic syndrome.