The exotoxin stimulates the gene and protein expression of CXCL12, as well as that of its receptors CXCR4 and ACKR3, mimicking the conditions observed in children afflicted with E.coli O157:H7 who further develop HUS where CXCL12 levels are similarly elevated. Here, ACKR3 is linked to hemolytic-uremic syndrome.