Center for Inflammatory Bowel Diseases, Division of Digestive Diseases, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA.
Antimicrob Agents Chemother. 2013 Jul;57(7):3214-23. doi: 10.1128/AAC.02633-12. Epub 2013 Apr 29.
Clostridium difficile infection (CDI) is a common and debilitating nosocomial infection with high morbidity and mortality. C. difficile mediates diarrhea and colitis by releasing two toxins, toxin A and toxin B. Since both toxins stimulate proinflammatory signaling pathways in human colonocytes and both are involved in the pathophysiology of CDI, neutralization of toxin A and B activities may represent an important therapeutic approach against CDI. Recent studies indicated that human monoclonal antibodies (MAbs) against toxins A and B reduce their cytotoxic and secretory activities and prevent CDI in hamsters. Moreover, anti-toxin A and anti-toxin B MAbs together with antibiotics also effectively reduced recurrent CDI in humans. However, whether these MAbs neutralize toxin A- and toxin B-associated immune responses in human colonic mucosa or human peripheral blood monocyte cells (PBMCs) has never been examined. We used fresh human colonic biopsy specimens and peripheral blood monocytes to evaluate the effects of these antibodies against toxin A- and B-associated cytokine release, proinflammatory signaling, and histologic damage. Incubation of anti-toxin A (MK3415) or anti-toxin B (MK6072) MAbs with human PBMCs significantly inhibited toxin A- and toxin B-mediated tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) expression. MK3415 and MK6072 also diminished toxin A- and toxin B-mediated NF-κB p65 phosphorylation in human monocytes, respectively, and significantly reduced toxin A- and B-induced TNF-α and IL-1β expression as well as histologic damage in human colonic explants. Our results underline the effectiveness of MK3415 and MK6072 in blocking C. difficile toxin A- and toxin B-mediated inflammatory responses and histologic damage.
艰难梭菌感染(CDI)是一种常见且使人虚弱的医院获得性感染,具有较高的发病率和死亡率。艰难梭菌通过释放两种毒素(毒素 A 和毒素 B)来介导腹泻和结肠炎。由于这两种毒素都能刺激人结肠细胞中的促炎信号通路,并且都参与 CDI 的病理生理学过程,因此中和毒素 A 和 B 的活性可能是治疗 CDI 的重要方法。最近的研究表明,针对毒素 A 和 B 的人源单克隆抗体(MAbs)可降低其细胞毒性和分泌活性,并可预防仓鼠的 CDI。此外,抗毒素 A 和抗毒素 B 的 MAbs 与抗生素一起也可有效地减少人类复发性 CDI。然而,这些 MAbs 是否能中和人结肠黏膜或人外周血单核细胞(PBMCs)中与毒素 A 和 B 相关的免疫反应尚未得到检验。我们使用新鲜的人结肠活检标本和外周血单核细胞来评估这些抗体对毒素 A 和 B 相关细胞因子释放、促炎信号和组织学损伤的影响。用抗毒素 A(MK3415)或抗毒素 B(MK6072)MAbs 孵育人 PBMCs 可显著抑制毒素 A 和毒素 B 介导的肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)表达。MK3415 和 MK6072 还分别降低了毒素 A 和毒素 B 介导的人单核细胞中 NF-κB p65 的磷酸化,显著减少了毒素 A 和 B 诱导的 TNF-α和 IL-1β表达以及人结肠外植体的组织学损伤。我们的研究结果强调了 MK3415 和 MK6072 在阻断艰难梭菌毒素 A 和 B 介导的炎症反应和组织学损伤方面的有效性。
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