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Toxins 2016, 8(5), 134; doi:10.3390/toxins8050134

Clostridium difficile Toxins A and B: Insights into Pathogenic Properties and Extraintestinal Effects

1
2nd Infectious Diseases Division, National Institute for Infectious Diseases “L. Spallanzani”, Rome 00149, Italy
2
Department of Science, Roma Tre University, Rome 00154, Italy
3
Department of Microbiology and Infectious Diseases, Concord Repatriation General Hospital, Sydney 2139, Australia
*
Author to whom correspondence should be addressed.
Academic Editors: Harald Genth and Michel R. Popoff
Received: 25 February 2016 / Revised: 22 April 2016 / Accepted: 25 April 2016 / Published: 3 May 2016
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Abstract

Clostridium difficile infection (CDI) has significant clinical impact especially on the elderly and/or immunocompromised patients. The pathogenicity of Clostridium difficile is mainly mediated by two exotoxins: toxin A (TcdA) and toxin B (TcdB). These toxins primarily disrupt the cytoskeletal structure and the tight junctions of target cells causing cell rounding and ultimately cell death. Detectable C. difficile toxemia is strongly associated with fulminant disease. However, besides the well-known intestinal damage, recent animal and in vitro studies have suggested a more far-reaching role for these toxins activity including cardiac, renal, and neurologic impairment. The creation of C. difficile strains with mutations in the genes encoding toxin A and B indicate that toxin B plays a major role in overall CDI pathogenesis. Novel insights, such as the role of a regulator protein (TcdE) on toxin production and binding interactions between albumin and C. difficile toxins, have recently been discovered and will be described. Our review focuses on the toxin-mediated pathogenic processes of CDI with an emphasis on recent studies. View Full-Text
Keywords: Clostridium difficile; toxins; pathogenesis Clostridium difficile; toxins; pathogenesis
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MDPI and ACS Style

Di Bella, S.; Ascenzi, P.; Siarakas, S.; Petrosillo, N.; di Masi, A. Clostridium difficile Toxins A and B: Insights into Pathogenic Properties and Extraintestinal Effects. Toxins 2016, 8, 134.

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