Internalization of Clostridium difficile cytotoxin into cultured human lung fibroblasts

In cultured human lung fibroblasts treated with Clostridium difficile cytotoxin, the latency before appearance of the cytopathogenic effect was dose-related with a minimum of 45 min. At 37°C, the toxin was accessible on all cells to inactivation with trypsin or neutralization with antitoxin during the first tenth of the latency. At 0°C, the toxin was accessible considerably longer. The cytopathogenic effect was reversibly prevented by the lysosomotropic agents chloroquine and ammonium chloride, which had to be added within one-fifth of the latency to protect all cells. In the presence of chloroquine, but not of ammonium chloride, the time period during which the toxin remained amenable to neutralization with antitoxin was prolonged. The protective effect of ammonium chloride was not influenced by dropping the extracellular pH to 4.5, but that of chloroquine was abolished. The expression of the intoxication was not affected by inhibitors of the DNA, RNA or protein synthesis. Inhibitors of the energy metabolism prevented the cytopathogenic effect when added before the last phase of the latency. The results suggest that expression of the cytopathogenic effect requires internalization of the toxin, and that metabolic energy but no macromolecular synthesis is needed for the action of the toxin after this internalization.     

A型肉毒毒素Hc结构域在大肠杆菌中的高水平表达及免疫原性

对A型肉毒毒素受体结合区Hc基因的全序列进行优化和人工合成,获得了全长1287bp,编码429aa的Hc基因。以pTIG-Trx为原核表达载体,实现了Hc在大肠杆菌中的高效可溶性表达及纯化,该表达水平可占可溶性全菌总蛋白的36%～53%,经一步亲和层析纯化可获得电泳级纯度的目的蛋白,在常规培养条件下,产量达到30mg/L以上。然后,纯化的重组蛋白Hc免疫小鼠后能够诱导产生高滴度特异性的抗体,也能诱导产生特异性的细胞免疫应答反应。小鼠体内A型肉毒毒素中和试验结果表明免疫组小鼠血清中含高滴度的体内中和抗体。结果表明,利用本实验的原核表达系统不仅能够高水平可溶性地表达A型肉毒毒素受体结合区Hc,而且重组Hc具有良好的免疫原性,可以用于制备治疗性抗毒素和作为亚单位候选疫苗用于预防A型肉毒毒素中毒。     

Effect of Frozen Storage Time on Heat Inactivation of Clostridium botulinum Type E Toxin

Type E toxin of Clostridium botulinum, stored in the frozen state, retained its original toxicity level but lost its heat stability as the storage time increased.     

Radioimmunoassay for Type A Toxin of Clostridium botulinum

A preparation of pure type A toxin of Clostridium botulinum was labeled with (131)I in the presence of chloramine-T and carrier-free isotope. The radioactive toxin ((131)I Tox) was used in a radioimmunoassay procedure similar to that of Berson and Yalow. Dilutions of antibody to the toxin, capable of binding 50% of the added (131)I Tox, were mixed with a sample of the labeled toxin and various concentrations of unlabeled toxin ('Cold' Tox). When concentration of Cold Tox were plotted against the ratio (131)I bound/(131)I not bound, a standard curve was established that could be used to estimate the concentration of Cold Tox in a test mixture. This assay was sensitive to as little as 100 mouse minimum lethal dose and was highly specific for the serological type of the toxin used.     

24株鸡源丁酸梭菌的分离鉴定及耐药基因与毒力基因携带情况

【目的】旨在对鸡源丁酸梭菌进行分离鉴定与安全性评估。【方法】利用厌氧培养方法对源自汶上芦花鸡与SPF鸡粪便样品进行丁酸梭菌的分离与纯化,挑选可疑菌落进行微生物质谱鉴定,进一步通过16S rRNA基因测序进行鉴定,16S rRNA测序结果与NCBI核苷酸数据库中丁酸梭菌的16S rRNA序列进行同源性分析;同时,进行所有分离株对氧氟沙星、头孢吡肟等9种药物的药敏试验,利用PCR方法进行mefA等23种耐药基因扩增,基于益生菌安全要求对样品进行alpha等4种梭菌毒素基因以及typeA等4种肉毒毒素基因的测定。【结果】共分离鉴定了24株丁酸梭菌。24株均对氧氟沙星等7种抗生素表现为敏感,L-1、L-6、L-12仅对新霉素表现为中介,L-19仅对头孢吡肟表现为中介。全部菌株的mefA等16种耐药基因结果全部为阴性,sul2、flor、blaTEM 3种耐药基因全部呈阳性,tetC携带率为79.2%,cmlA携带率为45.8%,blaOXA携带率为37.5%,aadB携带率为12.5%,qnrA携带率为4.2%。PCR结果显示所有分离菌株的alpha、beta、epsilon、iota等4种梭菌毒素基因携带率0%。全部分离菌株均未携带typeA、typeB、typeE、typeF 4种肉毒毒素基因。【结论】结果表明,从未饲喂抗生素和丁酸梭菌的汶上芦花鸡与SPF鸡群中获得的24株丁酸梭菌分离株达到预期的安全性要求,可作为益生添加菌的筛选参考株。     

腐败梭菌α毒素基因的克隆表达及其类毒素的免疫原性研究

根据GenBank公布的腐败梭菌α毒素基因序列,设计了一对引物,并以腐败梭菌基因组为模板,经PCR特异性扩增出腐败梭菌菌株HeB01的α毒素基因。序列分析表明,该基因产物大小为1323bp,与GenBank报道的4个腐败梭菌参考菌株α毒素基因序列同源性高于99·5%。将扩增的α毒素基因定向克隆到原核表达载体pQE30中,得到重组质粒pQE30-α,将重组质粒转化大肠杆菌M15中,得到重组菌株M15(pQE30-α),经IPTG诱导后,SDS-PAGE分析可见表达的48kD特异条带;Westernblot和ELISA检测实验表明:表达的α毒素与抗天然α毒素抗体发生特异性反应,说明α毒素蛋白具有较好的免疫原性。将表达的α毒素蛋白制成类毒素疫苗,免疫小鼠后,具有一定的保护能力,表明该重组菌株有望作为腐败梭菌基因工程类毒素疫苗的候选生产菌株。     

Development of an enzyme immunoassay for the detection of Clostridium novyi type B alpha toxin

Clostridium novyi type B alpha toxin was purified to homogeneity and shown to have a molecular weight of 200 kD by SDS polyacrylamide gel electrophoresis. The toxin was toxoided and used to produce a pair of non-interfering monoclonal antibodies. Their specificity was confirmed by immunoblotting and bioassay. The monoclonal antibodies were used to develop an enzyme immunoassay which was more sensitive than bioassay, and permitted less than 1 ng/ml toxin to be detected in a rapid 10 min assay format. Use of the assay can eliminate the requirement for in vivo testing of novyi toxin and toxoid, provided measurements of biological activity are not required. Because of its speed and sensitivity, the assay can be used to monitor toxin production during fermentation and as an alternative to bioassay to measure antigen content during toxoiding and vaccine formulation.     

Ultrastructural effects of Clostridium difficile toxin B on smooth muscle cells and fibroblasts

The mechanism by which Clostridium difficile toxin B causes cells in culture to round was investigated. Cultured human lung fibroblasts and rabbit aortic smooth muscle cells were treated with partially purified or purified toxin B and monitored by light and transmission electron microscopy (TEM). Both preparations caused progressive cell rounding which correlated with disorganization of actin-containing myofilament bundles. Thin myofilaments became fragmented and finally disappeared (after 24 h) and dense bodies became more prominent, while all other organelles appeared unaffected.     

Polymerase Chain Reaction Test for Differentiation of Five Toxin Types of Clostridium perfringens

In order to avoid the use of experimental animals, the polymerase chain reaction (PCR) method was applied to differentiate Clostridium perfringens into five toxin types. Twenty-two out of 23 strains tested produced the toxin(s) corresponding to the toxin gene(s) identified by PCR, and vice versa. Consequently, the gene typing was consistent with conventional typing by animal tests. Twenty-five strains were identified as types different from original ones by the PCR method as well as a toxin neutralization test. These findings suggest that the PCR method, which is easy and timesaving, is applicable to identify the toxin types of C. perfringens as an alternative to animal tests, and that beta-, epsilon- and iota-toxin genes might be lost by long-term preservation. The reasons why the strains lost the genes are discussed.     

Effect of Different Carbon and Nitrogen Sources on Clostridium argentinense Toxigenicity in Coculture withPseudomonas mendocina

The effect of different carbon and nitrogen sources on the production of toxin by Clostridium argentinense was examined. The toxin production by C. argentinense in coculture with Pseudomonas mendocina increased in all the cases in relation to that produced by monocultures independent of the nature of the source. Using dextrin as carbon source C. argentinense produced the highest levels of toxin both in monocultures (300 LD₅₀/mL) and in cocultures with P. mendocina (5000 LD₅₀/mL). Experiments run in a microfermenter showed that the slow growth of cocultures associated with the assimilation of dextrin and the pH and Eh profiles favoured the production of toxin. Of the nitrogen sources assayed, corn steep liquor sustained the highest levels of toxin in both monocultures and cocultures with 3 and 2.8 fold increases with respect to that obtained using proteose peptone. The toxin production by C. argentinense cultures and C. argentinense–P. mendocina cocultures was highly dependent on the nature of the carbon and nitrogen sources used in the culture media. Growth of C. argentinense on substrates slowly assimilated stimulated the production of toxin.     

Clostridium botulinum in the soil of Paraguay

Seventeen soil samples of Paraguay were examined for the presence of Clostridium botulinum. Botulinum type A, C1 and F toxins were detected in soil cultures. Type E toxin was not detected in any of soil cultures including those from river and lake shores.     

Clostridium difficile testing algorithms: What is practical and feasible?

There has been renewed interest in the laboratory diagnosis of Clostridium difficile infections due in large measure to the increase in both numbers and severity of cases of this disease. For the past two decades, enzyme-immunoassays (EIAs) for the detection of first C. difficile toxin A and then toxins A and B have been the most widely used diagnostic test for diagnosis of C. difficile infections. Recently this diagnostic approach has been called into question by the recognition that a screening test which detects glutamate dehydrogenase, a cell wall antigen of C. difficile, was significantly more sensitive than toxins A and B EIAs making it an effective screening test for C. difficile infection. Although sensitive, GDH lacks specificity and so if this test was utilized, a confirmatory test to differentiate false positives from true positives was needed. Studies to date have used cytotoxin neutralization or toxigenic culture as confirmatory tests but both of these have their limitations. A testing algorithm using rapid immunochromatographic devices for detection of GDH and toxins A and B as screening tests will give an accurate test result in approximately 90% of specimens within one hour when using cytotoxin neutralization as a reference method. For the other 10% of specimens, a third test would be needed in the algorithm. This test could be cytotoxin neutralization, toxigenic culture, or PCR for toxin or toxin operon genes.     

Structural Basis for Antibody Recognition in the Receptor-binding Domains of Toxins A and B from Clostridium difficile

Clostridium difficile infection is a serious and highly prevalent nosocomial disease in which the two large, Rho-glucosylating toxins TcdA and TcdB are the main virulence factors. We report for the first time crystal structures revealing how neutralizing and non-neutralizing single-domain antibodies (sdAbs) recognize the receptor-binding domains (RBDs) of TcdA and TcdB. Surprisingly, the complexes formed by two neutralizing antibodies recognizing TcdA do not show direct interference with the previously identified carbohydrate-binding sites, suggesting that neutralization of toxin activity may be mediated by mechanisms distinct from steric blockage of receptor binding. A camelid sdAb complex also reveals the molecular structure of the TcdB RBD for the first time, facilitating the crystallization of a strongly negatively charged protein fragment that has resisted previous attempts at crystallization and structure determination. Electrospray ionization mass spectrometry measurements confirm the stoichiometries of sdAbs observed in the crystal structures. These studies indicate how key epitopes in the RBDs from TcdA and TcdB are recognized by sdAbs, providing molecular insights into toxin structure and function and providing for the first time a basis for the design of highly specific toxin-specific therapeutic and diagnostic agents.     

Susceptibility of Mink to Clostridium Botulinum Type C Toxin

Investigations to determine the exact susceptibility of mink to Clostridium botulinum type C toxin clearly showed that mink were considerably less resistant to this toxin than has previously been described. Mink weighing approximately 900 g were killed by 360 MLD when toxin was mixed into the feed. By subcutaneous injection, the lethal dose was determined to be in the range of 18 to 36 MLD. When comparing the susceptibility per g of body weight after parenteral application of the toxin, mink proved to be less resistant than mice to this type of toxin. Continued feeding tests in mink with suspected material is pointed out as a preferable method for practical demonstrations of Clostridium botulinum type C toxin in cases where the toxin content in the suspected material is very low (1 MLD per g or less).     

神经毒素原性酪酸梭菌与E型肉毒梭菌毒素的精制及特性比较

对首次自Ｅ型肉毒中毒食品中分离到的一株神经毒素原性酪酸梭菌（ＬＣＬ１５５）所产生的神经毒素,同Ｅ型肉毒梭菌（Ｅ１５３）所产生的神经毒素进行了精制及特性比较,发现（１）两菌神经毒素的分子量,Ｎａｔｉｖｅ－ＰＡＧＥ测试均为３２０ｋＤａ;ＳＤＳ－ＰＡＧＥ测试则均为１４７ｋＤａ,非毒性非血凝素部分均为１２８ｋＤａ;用胰蛋白酶激活神经毒素后发现两菌神经毒素均由分子量为１０３ｋＤａ的Ｈ链和４８ｋＤａ的Ｌ链组成。（２）两菌神经毒素柱层析图像基本一致,但在菌体毒素提取效果及精制效果诸方面,分离的酪酸梭菌却都较差。（３）胰蛋白酶激活试验表明：两菌神经毒素达到最大毒力所需激活时间不等。在相同温度下,分离的酪酸梭菌毒素只需５ｍｉｎ,而Ｅ型肉毒梭菌毒素却需３０ｍｉｎ,提示两菌神经毒素激活动力学上存在差异。（４）琼脂双扩散试验结果表明两菌神经毒素的抗原性是一致的,没有发现沉淀线呈交叉或部分交叉现象。     

Neutralization of Clostridium difficile toxin A using antibody combinations

The pathogenicity of Clostridium difficile (C. difficile) is mediated by the release of two toxins, A and B. Both toxins contain large clusters of repeats known as cell wall binding (CWB) domains responsible for binding epithelial cell surfaces. Several murine monoclonal antibodies were generated against the CWB domain of toxin A and screened for their ability to neutralize the toxin individually and in combination. Three antibodies capable of neutralizing toxin A all recognized multiple sites on toxin A, suggesting that the extent of surface coverage may contribute to neutralization. Combination of two noncompeting antibodies, denoted 3358 and 3359, enhanced toxin A neutralization over saturating levels of single antibodies. Antibody 3358 increased the level of detectable CWB domain on the surface of cells, while 3359 inhibited CWB domain cell surface association. These results suggest that antibody combinations that cover a broader epitope space on the CWB repeat domains of toxin A (and potentially toxin B) and utilize multiple mechanisms to reduce toxin internalization may provide enhanced protection against C. difficile-associated diarrhea.     

Study of the presence of the spores of Clostridium botulinum in honey in Brazil

The isolation of Clostridium botulinum from honey samples is described. Botulism is characterized as an intoxication provoked by ingestion of contaminated foods with this toxin. Infant botulism happens by the ingestion of spores of C. botulinum together with food that in special conditions of the intestinal tract, such as those present in babies of less than 1 year old, will allow the germination and colonization of the intestine with production and absorption of botulinic toxin. The samples were subjected to dilution and to a thermal shock and cultivated in modified CMM (Difco). Cultures were subjected to Gram smears and toxicity tests in mice. The toxic cultures were purified in RFCA (Oxoid) plates and incubated in anaerobic jars. Positive samples were typed using the mouse assay neutralization test. From the 85 honey samples analyzed, six were positive for C. botulinum (7.06%), and identified as producers of type A, B, and D toxins.     

Activation of Clostridium botulinum type B and E derivative toxins with lysine-specific proteases

Abstract Clostridium botulinum type B and E derivative toxins were activated with lysyl endopeptidase or endoproteinase Lys-C, which splits only the bond involving the carboxyl group of a lysine residue. Type B toxin was more efficiently activated with lysyl endopeptidase; type E toxin was more efficiently activated with trypsin. Type B toxin was split by the lysine-specific protease into 2 fragments of molecular sizes indistinguishable from those induced with trypsin. Type E toxin was split by the same protease into 3 fragments, 2 of which had M _r identical to those obtained with trypsin, the other having an M _r less than that of the heavy chain but greater than that of the light chain. These results attest that both activation and nicking of type B and E derivative toxins are ascribable to cleavage, not of an arginyl, but of a lysyl bond.     

Interconversion of Type C and D Strains of Clostridium botulinum by Specific Bacteriophages

These studies show that Clostridium botulinum types C and D cultures can be cured of their prophages and converted to either type C or D depending on the specific phage used. Strains of types C and D were cured of their prophages and simultaneously ceased to produce their dominant toxins designated as C(1) and D, respectively. Cured nontoxigenic cultures derived from type C strain 162 were sensitive to the phages from the toxigenic type C strain 162 and type D strain South African. When cured nontoxigenic cultures derived from strain 162 were infected with the tox(+) phages from the 162 strain of type C and the South African strain of type D, they then produced toxin neutralized by types C and D antisera, respectively. Cured nontoxigenic cultures isolated from the type D South African strain were only sensitive to the parent phage, and, when reinfected with the tox(+) phage, they produced toxin neutralized by type D antiserum. Type C strain 153 and type D strain 1873, when cured of their respective prophages, also ceased to produce toxins C(1) and D, but, unlike strain 162 and the South African strain, they continued to produce a toxin designated as C(2). When the cured cultures from strains 153 and 1873 were infected with the tox(+) phage from type D strain 1873, the cultures simultaneously produced toxin that was neutralized by type D antiserum. When these cured cultures were infected with the tox(+) phage from type C strain 153, the cultures produced toxin that was neutralized by type C antiserum. These studies with the four strains of C. botulinum confirm that the toxigenicity of types C and D strains requires the continued participation of tox(+) phages. Evidence is presented that types C and D cultures may arise from a common nontoxigenic strain.     

Tests for the diagnosis of Clostridium difficile infection: the next generation

Clostridium difficile (C. difficile) causes 25-30% of cases of antibiotic associated diarrhea and most cases of pseudomembranous colitis. Patients presenting with diarrhea after hospitalization for 3 or more days should be tested for C. difficile. There are many options available for testing, each of which has inherent advantages and disadvantages. Most laboratories perform toxin testing using an enzyme immunoassay method. In general these tests have sensitivities ranging from 60 to 70% and specificities of 98%. When using these methods, symptomatic patients with negative tests should be tested by another more sensitive method. Until recently, cell culture cytotoxicity neutralization assays (CCNAs) were considered the gold standard in the U.S. A two-step algorithm using an EIA for glutamate dehydrogenase detection followed by testing positives using CCNA, offered an improved alternative until the availability of molecular assays. Although early studies that compared the GDH assay to CCNA demonstrated high sensitivity and negative predictive values, more recent comparisons to toxigenic culture and PCR have shown the sensitivity to be in the mid to high 80's. When testing using a sensitive assay, repeat testing is not cost-effective. Outbreaks caused by a toxin variant epidemic strain have renewed interest in bacterial culture. Toxigenic culture has emerged as the new gold standard against which newer assays should be compared. However, there is no agreed upon standard method for culture performance. At least 4 FDA cleared nucleic acid amplification assays are available to clinical laboratories and several of these have been well evaluated in the literature. Because these assays detect a gene that encodes toxin and not the toxin itself it is important that laboratories test only patients with diarrhea. These molecular assays have been shown to be superior to toxin EIAs, CCNA and 2-step algorithms, but not to toxigenic culture. More studies are needed to assess the impact of molecular tests on treatment and nosocomial spread of Clostridium difficile infections.