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Pathogenesis of Clostridium difficile infection and its potential role in inflammatory bowel disease

Monaghan, Tanya M.; Cockayne, Alan; MAHIDA, YASH

Authors

TANYA MONAGHAN Tanya.Monaghan@nottingham.ac.uk
Clinical Associate Professor in Luminal Gastroenterology

Alan Cockayne

YASH MAHIDA yash.mahida@nottingham.ac.uk
Professor of Medicine



Abstract

mild diarrhea to life-threatening colitis. Over the last 15 years, there has been a marked increase in the incidence of C. difficile infection, which predominantly affects elderly patients on antibiotics. More recently, there has been significant interest in the association between inflammatory bowel disease (IBD) and C. difficile infection. This review article discusses in some detail current knowledge of the mechanisms by which C. difficile toxins may mediate mucosal inflammation, together with the role of cell wall components of the microorganism in disease pathogenesis. Innate and adaptive host responses to C. difficile toxins and other components are described and include consideration of the potential role of known mucosal changes in IBD that may lead to an enhanced inflammatory response in the presence of C. difficile infection. Recent studies, which have characterized resident microbiota that may mediate protection against colonization by C. difficile, including their mechanisms of action, are also discussed. This includes the role of bile acids and 7?-dehydroxylase-expressing bacteria, such as Clostridium scindens. Recent studies suggest a higher carriage rate of C. difficile in patients with IBD. It is anticipated that future studies will determine the role of dysbiosis in IBD in predisposing to colonization with C. difficile.

Journal Article Type Article
Acceptance Date Mar 31, 2015
Online Publication Date Jul 1, 2015
Publication Date Aug 1, 2015
Deposit Date Sep 7, 2017
Print ISSN 1078-0998
Electronic ISSN 1536-4844
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 21
Issue 8
DOI https://doi.org/10.1097/MIB.0000000000000461
Public URL https://nottingham-repository.worktribe.com/output/1111880
PMID 00035919