Department of Microbiology and Immunology, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA.
Department of Microbiology and Immunology, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA.
Cell Rep. 2024 May 28;43(5):114245. doi: 10.1016/j.celrep.2024.114245. Epub 2024 May 17.
Recurrent Clostridioides difficile infection (CDI) results in significant morbidity and mortality. We previously established that CDI in mice does not protect against reinfection and is associated with poor pathogen-specific B cell memory (Bmem), recapitulating our observations with human Bmem. Here, we demonstrate that the secreted toxin TcdB2 is responsible for subversion of Bmem responses. TcdB2 from an endemic C. difficile strain delayed immunoglobulin G (IgG) class switch following vaccination, attenuated IgG recall to a vaccine booster, and prevented germinal center formation. The mechanism of TcdB2 action included increased B cell CXCR4 expression and responsiveness to its ligand CXCL12, accounting for altered cell migration and a failure of germinal center-dependent Bmem. These results were reproduced in a C. difficile infection model, and a US Food and Drug Administration (FDA)-approved CXCR4-blocking drug rescued germinal center formation. We therefore provide mechanistic insights into C. difficile-associated pathogenesis and illuminate a target for clinical intervention to limit recurrent disease.
复发性艰难梭菌感染 (CDI) 会导致严重的发病率和死亡率。我们之前已经证实,小鼠中的 CDI 不能预防再感染,并且与病原体特异性 B 细胞记忆 (Bmem) 不良有关,这与我们对人类 Bmem 的观察结果一致。在这里,我们证明了分泌的毒素 TcdB2 负责颠覆 Bmem 反应。来自地方性艰难梭菌菌株的 TcdB2 在接种疫苗后延迟了免疫球蛋白 G (IgG) 类别转换,减弱了对疫苗加强剂的 IgG 回忆反应,并阻止了生发中心的形成。TcdB2 的作用机制包括增加 B 细胞 CXCR4 的表达和对其配体 CXCL12 的反应性,这导致了细胞迁移的改变和生发中心依赖性 Bmem 的失败。这些结果在艰难梭菌感染模型中得到了重现,并且美国食品和药物管理局 (FDA) 批准的 CXCR4 阻断药物挽救了生发中心的形成。因此,我们为艰难梭菌相关发病机制提供了机制上的见解,并为临床干预以限制复发性疾病提供了一个目标。