Next Article in Journal
Zebrafish Sensitivity to Botulinum Neurotoxins
Next Article in Special Issue
The Regulatory Networks That Control Clostridium difficile Toxin Synthesis
Previous Article in Journal
An Immunosuppressant Peptide from the Hard Tick Amblyomma variegatum
Previous Article in Special Issue
Metal Ion Activation of Clostridium sordellii Lethal Toxin and Clostridium difficile Toxin B
Article Menu
Issue 5 (May) cover image

Export Article

Open AccessFeature PaperReview
Toxins 2016, 8(5), 134;

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

2nd Infectious Diseases Division, National Institute for Infectious Diseases “L. Spallanzani”, Rome 00149, Italy
Department of Science, Roma Tre University, Rome 00154, Italy
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
Full-Text   |   PDF [3816 KB, uploaded 3 May 2016]   |  


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

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Share & Cite This Article

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.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Toxins EISSN 2072-6651 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top