Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Gastroenterol Hepatol. 2010 Apr;25(4):832-8. doi: 10.1111/j.1440-1746.2009.06135.x. Epub 2010 Jan 14.
Immunosuppressive therapy may precipitate Clostridium difficile associated disease (CDAD). We evaluated the role of cyclosporin in the development of CDAD in the experimental mouse model and studied the effect of probiotic and epidermal growth factor (EGF) as biotherapeutics measures.
BALB/c mice (n = 24) were divided into four groups. Group I animals not given any inoculum served as controls. Animals in the remaining three groups (Group II, III and IV) were given cyclosporin daily from days 1-7 followed by C. difficile inoculum on day 8. Additionally, the animals received Lactobacillus acidophilus (Group III) and EGF (Group IV) for one-week post C. difficile challenge. The animals were evaluated for colonization and toxin production by C. difficile, myeloperoxidase (MPO) activity and histopathological changes.
Clostridium difficile was colonized and elaborated its toxins in animals receiving cyclosporin and C. difficile. MPO activity was significantly higher (P < 0.05) and histopathological epithelial damage, cryptitis and acute inflammatory changes were seen in the cecum and colon. C. difficile count, toxins A and B titers and MPO activity were significantly lowered (P < 0.05) in animals receiving probiotic and EGF. Histopathologically, mucodepletion and inflammatory infiltrate were decreased in the biotherapeutic receiving animals.
Cyclosporin led to the development of mild to moderate CDAD in animals. Administration of biotherapeutics reduced the severity of CDAD. Future clinical trials are needed for further investigation of these potential biotherapeutic measures.
免疫抑制疗法可能会引发艰难梭菌相关性疾病(CDAD)。我们在实验性小鼠模型中评估了环孢素在 CDAD 发展中的作用,并研究了益生菌和表皮生长因子(EGF)作为生物治疗措施的效果。
BALB/c 小鼠(n = 24)分为四组。第 I 组动物未给予任何接种物作为对照。其余三组(第 II、III 和 IV 组)动物从第 1 天至第 7 天每天给予环孢素,然后在第 8 天给予艰难梭菌接种物。此外,在艰难梭菌挑战后一周,动物接受嗜酸乳杆菌(第 III 组)和 EGF(第 IV 组)治疗。通过艰难梭菌定植和毒素产生、髓过氧化物酶(MPO)活性和组织病理学变化评估动物。
接受环孢素和艰难梭菌治疗的动物中,艰难梭菌定植并产生其毒素。MPO 活性显著升高(P < 0.05),回肠和结肠出现上皮损伤、隐窝炎和急性炎症变化。接受益生菌和 EGF 的动物的艰难梭菌计数、毒素 A 和 B 滴度和 MPO 活性显著降低(P < 0.05)。组织病理学上,接受生物治疗的动物的黏膜缺失和炎症浸润减少。
环孢素导致动物发生轻度至中度 CDAD。生物治疗的给药降低了 CDAD 的严重程度。需要进一步的临床试验来进一步研究这些潜在的生物治疗措施。