Clostridium Difficile Infection: An Immunological Conundrum

Arch Med Res. 2018 Aug;49(6):359-364. doi: 10.1016/j.arcmed.2018.11.002. Epub 2019 Jan 4.

Abstract

The lack of comprehensive understanding of the way immunity backfires on incidence and complications has made Clostridium difficile infection (CDI), the infectious disease of our times, as evidenced by in the parallel course it follows along epidemic of chronic degenerative diseases. Within these ailments, if as suspected the main effect of Clostridium difficile A and B toxins depends on inflammation, then aberrant immune function due to antibiotics would explain IBD triggering after treatment but also, the higher incidence and mortality surrounding disorders that are inflammatory and/or that show abatement of neutrophils. This review will discuss severity of the disease in terms of challenges to immunity during the progression of acute illness. We will identify the common signals in the communication between microbiota and inflammatory cells, as well as the sequestration of the regulatory network by Clostridium difficile, which leads to tissue damage and prevents its elimination from intestinal lumen.

Keywords: Antimicrobial effects over immunity; CDI; Clostridium difficile; IBD; Inflammatory response training; Innate immunity; Intestinal bowel disease; Microbiome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / metabolism
  • Bacterial Toxins / metabolism
  • Clostridioides difficile / immunology*
  • Clostridium Infections / drug therapy
  • Clostridium Infections / epidemiology*
  • Clostridium Infections / immunology*
  • Disease Progression
  • Enterotoxins / metabolism
  • Gastrointestinal Microbiome / immunology*
  • Humans
  • Inflammatory Bowel Diseases / microbiology*
  • Intestines / microbiology
  • Neutrophils / immunology

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Bacterial Toxins
  • Enterotoxins
  • tcdA protein, Clostridium difficile
  • toxB protein, Clostridium difficile