the enterotoxicity of clostridium difficile toxins艰难梭菌的enterotoxicity毒素.pdfVIP

Toxins 2010, 2, 1848-1880; doi:10.3390/toxins2071848 OPEN ACCESS toxins ISSN 2072-6651 /journal/toxins Review The Enterotoxicity of Clostridium difficile Toxins Xingmin Sun 1, Tor Savidge 2 and Hanping Feng 1,* 1 Tufts Cummings School of Veterinary Medicine, North Grafton, MA, 01536, USA; E-Mail: Xingmin.sun@ 2 The University of Texas Medical Branch, Galveston, TX, 77555, USA; E-Mail: tcsavidge@ * Author to whom correspondence should be addressed; E-Mail: hanping.feng@; Tel.: +1-508-887-4252; Fax: +1-508-839-7911. Received: 18 June 2010; in revised form: 23 June 2010 / Accepted: 9 July 2010 / Published: 14 July 2010 Abstract: The major virulence factors of Clostridium difficile infection (CDI) are two large exotoxins A (TcdA) and B (TcdB). However, our understanding of the specific roles of these toxins in CDI is still evolving. It is now accepted that both toxins are enterotoxic and proinflammatory in the human intestine. Both purified TcdA and TcdB are capable of inducing the pathophysiology of CDI, although most studies have focused on TcdA. C. difficile toxins exert a wide array of biological activities by acting directly on intestinal epithelial cells. Alternatively, the toxins may target immune cells and neurons once the intestinal epithelial barrier is disrupted. The toxins may also act indirectly by stimulating cells to produce chemokines, proinflammatory cytokines, neuropeptides and other neuroimmune