Artigo Revisado por pares

Clostridium difficile toxin B is an inflammatory enterotoxin in human intestine

2003; Elsevier BV; Volume: 125; Issue: 2 Linguagem: Inglês

10.1016/s0016-5085(03)00902-8

ISSN

1528-0012

Autores

Tor Savidge, Weihua Pan, Paul Newman, Michael J. O’Brien, Pauline M. Anton, Charalabos Pothoulakis,

Tópico(s)

Helicobacter pylori-related gastroenterology studies

Resumo

Background & aims:Clostridium difficile causes antibiotic-associated diarrhea and pseudomembranous colitis, diseases afflicting millions of people each year. Although C. difficile releases 2 structurally similar exotoxins, toxin A and toxin B, animal experiments suggest that only toxin A mediates diarrhea and enterocolitis. However, toxin A-negative/toxin B-positive strains of C. difficile recently were isolated from patients with antibiotic-associated diarrhea and colitis, indicating that toxin B also may be pathogenic in humans.Methods:Here we used subcutaneously transplanted human intestinal xenografts in immunodeficient mice to generate a chimeric animal model for C. difficile toxin-induced pathology of human intestine.Results:We found that intraluminal toxin B, like equivalent concentrations of toxin A, induced intestinal epithelial cell damage, increased mucosal permeability, stimulated interleukin (IL)-8 synthesis, and caused an acute inflammatory response characterized by neutrophil recruitment and tissue damage. Laser capture microdissection and real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR) showed that intestinal epithelial cell-specific IL-8 gene expression also was increased significantly after luminal exposure to C. difficile toxins in vivo.Conclusions:We conclude that C. difficile toxin B, like toxin A, is a potent inflammatory enterotoxin for human intestine. Future therapeutic or vaccine strategies for C. difficile infection therefore need to target both toxins.

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