Darvishi Mohammad, Rafsanjani Seyed Mahmoud Reza Hashemi, Nouri Majid, Abbaszadeh Saber, Heidari-Soureshjani Saeid, Kasiri Karamali, Rahimian Ghorbanali
Infectious Diseases and Tropical Medicine Research Center (IDTMRC), School of Aerospace and Subaquatic Medicine, Aja University of Medical Sciences, Tehran, Iran.
Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Infect Disord Drug Targets. 2025;25(3):e18715265313944. doi: 10.2174/0118715265313944240726115600.
Clostridium difficile is an opportunistic infection that can lead to antibiotic- associated diarrhea and toxic megacolon.
This systematic review study aimed to investigate polyphenols' antibacterial and antitoxin properties and their effects on reducing complications related to C. difficile Infections (CDI).
This systematic review was conducted following the PRISMA guideline 2020. Multiple databases, including Web of Science, PubMed, Cochrane Library, EMBASE, and Scopus, were searched thoroughly for existing literature. After considering the inclusion and exclusion criteria for the review, 18 articles were included. Data were collected and registered into an Excel file for further investigations and conclusions.
Polyphenols by reducing Reactive Oxygen Species (ROS) levels, increasing inflammatory factor Interleukin 10 (IL-10), reducing Nuclear Factor kappa B (NF-κB) and Tumour Necrosis Factor- α (TNF-α), IL-6, IL-1α, IL-1β, Granulocyte Colony-stimulating Factor (G-CSF), and Monocyte Chemoattractant Protein-1 (MCP-1) and Macrophage Inflammatory Protein-1 alpha (MIP-1α) levels, and regulating the expression of Bcl-2 and Bax, make the growth and replication conditions of more difficult and prevent it from producing toxins. Furthermore, polyphenols can exhibit prebiotic properties, promoting the growth of beneficial and species and consequently regulating gut microbiota, exerting antimicrobial activities against C. difficile. They also induce their beneficial effects by inhibiting the production of TcdA and TcdB.
Polyphenols have been reported to inhibit C. difficile growth and toxin production by several mechanisms in preclinical studies. However, more clinical studies are needed to investigate their safety in humans.
艰难梭菌是一种机会性感染病原体，可导致抗生素相关性腹泻和中毒性巨结肠。
本系统评价研究旨在调查多酚的抗菌和抗毒素特性及其对减少艰难梭菌感染（CDI）相关并发症的作用。
本系统评价按照2020年PRISMA指南进行。全面检索了多个数据库，包括科学网、PubMed、考克兰图书馆、EMBASE和Scopus，以查找现有文献。在考虑了本评价的纳入和排除标准后，纳入了18篇文章。收集数据并记录到Excel文件中，以便进一步研究和得出结论。
多酚通过降低活性氧（ROS）水平、增加炎性因子白细胞介素10（IL-10）、降低核因子κB（NF-κB）和肿瘤坏死因子-α（TNF-α）、IL-6、IL-1α、IL-1β、粒细胞集落刺激因子（G-CSF）、单核细胞趋化蛋白-1（MCP-1）和巨噬细胞炎性蛋白-1α（MIP-1α）水平，并调节Bcl-2和Bax的表达，使（艰难梭菌）的生长和复制条件更恶劣，并阻止其产生毒素。此外，多酚可表现出益生元特性，促进有益菌和（其他）菌种的生长，从而调节肠道微生物群，对艰难梭菌发挥抗菌活性。它们还通过抑制毒素A（TcdA）和毒素B（TcdB）的产生发挥有益作用。
临床前研究已报道多酚可通过多种机制抑制艰难梭菌的生长和毒素产生。然而，需要更多的临床研究来调查其对人类的安全性。
