Abstract:
:Clostridium difficile infection (CDI) is mediated by two major exotoxins, toxin A (TcdA) and toxin B (TcdB), that damage the colonic epithelial barrier and induce inflammatory responses. The function of the colonic vascular barrier during CDI has been relatively understudied. Here we report increased colonic vascular permeability in CDI mice and elevated vascular endothelial growth factor A (VEGF-A), which was induced in vivo by infection with TcdA- and/or TcdB-producing C. difficile strains but not with a TcdA-TcdB- isogenic mutant. TcdA or TcdB also induced the expression of VEGF-A in human colonic mucosal biopsies. Hypoxia-inducible factor signalling appeared to mediate toxin-induced VEGF production in colonocytes, which can further stimulate human intestinal microvascular endothelial cells. Both neutralization of VEGF-A and inhibition of its signalling pathway attenuated CDI in vivo. Compared to healthy controls, CDI patients had significantly higher serum VEGF-A that subsequently decreased after treatment. Our findings indicate critical roles for toxin-induced VEGF-A and colonic vascular permeability in CDI pathogenesis and may also point to the pathophysiological significance of the gut vascular barrier in response to virulence factors of enteric pathogens. As an alternative to pathogen-targeted therapy, this study may enable new host-directed therapeutic approaches for severe, refractory CDI.
journal_name
Nat Microbioljournal_title
Nature microbiologyauthors
Huang J,Kelly CP,Bakirtzi K,Villafuerte Gálvez JA,Lyras D,Mileto SJ,Larcombe S,Xu H,Yang X,Shields KS,Zhu W,Zhang Y,Goldsmith JD,Patel IJ,Hansen J,Huang M,Yla-Herttuala S,Moss AC,Paredes-Sabja D,Pothoulakis C,Shahdoi
10.1038/s41564-018-0300-xsubject
Has Abstractpub_date
2019-02-01 00:00:00pages
269-279issue
2issn
2058-5276pii
10.1038/s41564-018-0300-xjournal_volume
4pub_type
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