1887

Abstract

infection (CDI) causes toxin-mediated enteropathy, such as antibiotic-associated diarrhoea and pseudomembranous colitis. Rho-glucosylating toxin A (TcdA) and toxin B (TcdB) have been clearly implicated in pathogenesis, whereas the virulence of binary toxin (CDT) is still debated.

We hypothesized that CDT is involved in the host immune response and plays a pivotal role in establishing virulence by modulating pro-inflammatory cytokine production; this is achieved through the integral Toll-like receptor (TLR) signalling pathways.

The aim of the present study was to determine whether and how CDT impacts macrophages compared to TcdA or TcdB by examining the induction of CXC chemokine ligand 2 (CXCL2) and tumour necrosis factor-α (TNF-α), both of which are crucial in mediating local and systematic inflammatory responses.

RAW264.7 cells or transfected human embryonic kidney (HEK) 293 T cells were incubated with TcdA, TcdB, or CDT. In some experiments, a neutralizing antibody against TLR2 or TLR4, or myeloid differentiation 88 inhibitory peptide were added. The amount of CXCL2 and TNF-α secreted was then measured.

In RAW264.7 macrophages, CXCL2 and TNF-α were produced via the Toll-like receptor 2 (TLR2) or Toll-like receptor 4 (TLR4) pathway in a TcdA, TcdB, or CDT dose-dependent manner. Interleukin-8 secretion was induced in TLR4/MD2/CD14-transfected, but not in TLR2-transfected, HEK 293 T cells following TcdB or CDT exposure.

Our results showed that toxins, including CDT, enhanced macrophage-mediated CXCL2 and TNF-α production via TLR2 and TLR4, indicating that CDT affects host immune responses.

Funding
This study was supported by the:
  • Ministry of Education, Culture, Sports, Science and Technology
    • Principle Award Recipient: KazuhiroTateda
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001342
2021-04-08
2024-04-20
Loading full text...

Full text loading...

/deliver/fulltext/jmm/70/4/jmm001342.html?itemId=/content/journal/jmm/10.1099/jmm.0.001342&mimeType=html&fmt=ahah

References

  1. Bartlett JG. Historical perspectives on studies of Clostridium difficile and C. difficile infection. Clin Infect Dis 2008; 46 Suppl 1:S4–S11 [View Article][PubMed]
    [Google Scholar]
  2. Johnson S, Gerding DN. Clostridium difficile-associated diarrhea. Clin Infect Dis 1998; 26:1027–1034 [View Article][PubMed]
    [Google Scholar]
  3. Just I, Gerhard R. Large clostridial cytotoxins. Rev Physiol Biochem Pharmacol 2004; 152:23–47 [View Article][PubMed]
    [Google Scholar]
  4. Gerding DN, Johnson S, Rupnik M, Aktories K. Clostridium difficile binary toxin CDT. Gut Microbes 2014; 5:15–27 [View Article]
    [Google Scholar]
  5. Papatheodorou P, Carette JE, Bell GW, Schwan C, Guttenberg G et al. Lipolysis-stimulated lipoprotein receptor (LSR) is the host receptor for the binary toxin Clostridium difficile transferase (CDT). Proc Natl Acad Sci U S A 2011; 108:16422–16427 [View Article][PubMed]
    [Google Scholar]
  6. McEllistrem MC, Carman RJ, Gerding DN, Genheimer CW, Zheng L. A hospital outbreak of Clostridium difficile disease associated with isolates carrying binary toxin genes. Clin Infect Dis 2005; 40:265–272 [View Article][PubMed]
    [Google Scholar]
  7. Barbut F, Mastrantonio P, Delmée M, Brazier J, Kuijper E et al. Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterisation of the isolates. Clin Microbiol Infect 2007; 13:1048–1057 [View Article][PubMed]
    [Google Scholar]
  8. Bacci S, Mølbak K, Kjeldsen MK, Olsen KEP. Binary toxin and death after Clostridium difficile infection. Emerg Infect Dis 2011; 17:976–982 [View Article][PubMed]
    [Google Scholar]
  9. Stewart DB, Berg A, Hegarty J. Predicting recurrence of C. difficile colitis using bacterial virulence factors: binary toxin is the key. J Gastrointest Surg 2013; 17:118–125 [View Article][PubMed]
    [Google Scholar]
  10. Perelle S, Gibert M, Bourlioux P, Corthier G, Popoff MR. Production of a complete binary toxin (actin-specific ADP-ribosyltransferase) by Clostridium difficile CD196. Infect Immun 1997; 65:1402–1407 [View Article][PubMed]
    [Google Scholar]
  11. Fujitani S, George WL, Murthy AR. Comparison of clinical severity score indices for Clostridium difficile infection. Infect Control Hosp Epidemiol 2011; 32:220–228 [View Article][PubMed]
    [Google Scholar]
  12. Kelly CP. Leukocyte adhesion in gastrointestinal inflammation. Curr Opin Gastroenterol 1993; 9:962–970 [View Article]
    [Google Scholar]
  13. Springer TA. Traffic signals for lymphocyte recirculation and leukocyte emigration: the multistep paradigm. Cell 1994; 76:301–314 [View Article][PubMed]
    [Google Scholar]
  14. Miller MD, Krangel MS. Biology and biochemistry of the chemokines: a family of chemotactic and inflammatory cytokines. Crit Rev Immunol 1992; 12:17–46[PubMed]
    [Google Scholar]
  15. Wolpe SD, Sherry B, Juers D, Davatelis G, Yurt RW et al. Identification and characterization of macrophage inflammatory protein 2. Proc Natl Acad Sci U S A 1989; 86:612–616 [View Article][PubMed]
    [Google Scholar]
  16. Feng L, Xia Y, Yoshimura T, Wilson CB. Modulation of neutrophil influx in glomerulonephritis in the rat with anti-macrophage inflammatory protein-2 (MIP-2) antibody. J Clin Invest 1995; 95:1009–1017 [View Article][PubMed]
    [Google Scholar]
  17. Driscoll KE, Hassenbein DG, Carter J, Poynter J, Asquith TN et al. Macrophage inflammatory proteins 1 and 2: expression by rat alveolar macrophages, fibroblasts, and epithelial cells and in rat lung after mineral dust exposure. Am J Respir Cell Mol Biol 1993; 8:311–318 [View Article][PubMed]
    [Google Scholar]
  18. Shanley TP, Schmal H, Warner RL, Schmid E, Friedl HP et al. Requirement for C-X-C chemokines (macrophage inflammatory protein-2 and cytokine-induced neutrophil chemoattractant) in IgG immune complex-induced lung injury. J Immunol 1997; 158:3439–3448[PubMed]
    [Google Scholar]
  19. Castagliuolo I, Keates AC, Wang CC, Pasha A, Valenick L et al. Clostridium difficile toxin A stimulates macrophage-inflammatory protein-2 production in rat intestinal epithelial cells. J Immunol 1998; 160:6039–6045[PubMed]
    [Google Scholar]
  20. Nakagawa T, Mori N, Kajiwara C, Kimura S, Akasaka Y et al. Endogenous IL-17 as a factor determining the severity of Clostridium difficile infection in mice. J Med Microbiol 2016; 65:821–827 [View Article][PubMed]
    [Google Scholar]
  21. Cowardin CA, Buonomo EL, Saleh MM, Wilson MG, Burgess SL et al. The binary toxin CDT enhances Clostridium difficile virulence by suppressing protective colonic eosinophilia. Nat Microbiol 2016; 1:16108 [View Article][PubMed]
    [Google Scholar]
  22. Sadighi Akha AA, Theriot CM, Erb-Downward JR, McDermott AJ, Falkowski NR et al. Acute infection of mice with Clostridium difficile leads to eIF2α phosphorylation and pro-survival signalling as part of the mucosal inflammatory response. Immunology 2013; 140:111–122 [View Article][PubMed]
    [Google Scholar]
  23. Sun X, He X, Tzipori S, Gerhard R, Feng H. Essential role of the glucosyltransferase activity in Clostridium difficile toxin-induced secretion of TNF-alpha by macrophages. Microb Pathog 2009; 46:298–305 [View Article][PubMed]
    [Google Scholar]
  24. Huang T, Perez-Cordon G, Shi L, Li G, Sun X et al. Clostridium difficile toxin B intoxicated mouse colonic epithelial CT26 cells stimulate the activation of dendritic cells. Pathog Dis 2015; 73:ftv008 [View Article][PubMed]
    [Google Scholar]
  25. Wiese A, Münstermann M, Gutsmann T, Lindner B, Kawahara K et al. Molecular mechanisms of polymyxin B-membrane interactions: direct correlation between surface charge density and self-promoted transport. J Membr Biol 1998; 162:127–138 [View Article][PubMed]
    [Google Scholar]
  26. Echizen K, Hirose O, Maeda Y, Oshima M. Inflammation in gastric cancer: interplay of the COX-2/prostaglandin E2 and Toll-like receptor/MyD88 pathways. Cancer Sci 2016; 107:391–397 [View Article][PubMed]
    [Google Scholar]
  27. Hernández Del Pino RE, Barbero AM, Español Laureano Ángel, Morro LS, Pasquinelli V. The adaptive immune response to Clostridioides difficile: A tricky balance between immunoprotection and immunopathogenesis. J Leukoc Biol 2021; 109:1–16 [View Article][PubMed]
    [Google Scholar]
  28. Castagliuolo I, Kelly CP, Qiu BS, Nikulasson ST, LaMont JT et al. IL-11 inhibits Clostridium difficile toxin A enterotoxicity in rat ileum. Am J Physiol 1997; 273:G333–G341 [View Article][PubMed]
    [Google Scholar]
  29. Souza MH, Melo-Filho AA, Rocha MF, Lyerly DM, Cunha FQ et al. The involvement of macrophage-derived tumour necrosis factor and lipoxygenase products on the neutrophil recruitment induced by Clostridium difficile toxin B. Immunology 1997; 91:281–288 [View Article][PubMed]
    [Google Scholar]
  30. Shen C, de Hertogh G, Bullens DMA, Van Assche G, Geboes K et al. Remission-inducing effect of anti-TNF monoclonal antibody in TNBS colitis: mechanisms beyond neutralization?. Inflamm Bowel Dis 2007; 13:308–316 [View Article][PubMed]
    [Google Scholar]
  31. van Aubel RAMH, Keestra AM, Krooshoop DJEB, van Eden W, van Putten JPM. Ligand-Induced differential cross-regulation of Toll-like receptors 2, 4 and 5 in intestinal epithelial cells. Mol Immunol 2007; 44:3702–3714 [View Article][PubMed]
    [Google Scholar]
  32. Lorenz E. TLR2 and TLR4 expression during bacterial infections. Curr Pharm Des 2006; 12:4185–4193 [View Article][PubMed]
    [Google Scholar]
  33. Ryan A, Lynch M, Smith SM, Amu S, Nel HJ et al. A role for TLR4 in Clostridium difficile infection and the recognition of surface layer proteins. PLoS Pathog 2011; 7:e1002076 [View Article][PubMed]
    [Google Scholar]
  34. Oliveira-Nascimento L, Massari P, Wetzler LM. The role of TLR2 in infection and immunity. Front Immunol 2012; 3:79 [View Article][PubMed]
    [Google Scholar]
  35. Simpson M, Frisbee A, Kumar P, Schwan C, Aktories K et al. Clostridioides difficile binary toxin (CDT) is recognized by the TLR2/6 heterodimer to induce an NF-κB response. J Infect Dis 2020jiaa620 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001342
Loading
/content/journal/jmm/10.1099/jmm.0.001342
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error