艰难梭菌A毒素的细胞致死活性研究

本文报道艰难梭菌Ａ毒素对４种培养细胞的细胞致死活性的探讨。４种培养细胞为Ｖｅｒｏ（非洲绿猴肾细胞）细胞、ＴＰＣ─１（人甲状腺肿瘤细胞）细胞、ＮＩＨ３Ｔ３细胞（小鼠成纤维细胞）及将ｒａｓ癌基因转基因于ＮＩＨ３Ｔ３细胞的ＮＩＨ３Ｔ３ｒａｓ细胞。应用台酚蓝排除能试验、噻唑蓝（ＭＴＳ）比色、细胞膜损害测定试验、荧光显微术观察细胞核的形态变化等测定Ａ毒素细胞致死活性。实验表明：４种培养细胞系对Ａ毒素细胞圆缩化作用的敏感性依次为ＮＩＨ３Ｔ３ｒａｓ,ＴＰＣ─１,Ｖｅｒｏ,ＮＩＨ３Ｔ３细胞。而对Ａ毒素细胞致死活性的敏感性依次为ＴＰＣ─１,ＮＩＨ３Ｔ３,Ｖｅｒｏ,ＮＩＨ３Ｔ３ｒａｓ细胞。从而得知Ａ毒素的细胞致死活性不但依细胞种类不同而不同,而且也不一定与Ａ毒素的细胞圆缩化作用有关。肿瘤细胞ＴＰＣ─１细胞对Ａ毒素致死活性有特殊敏感性。以上结果对探索抗癌新药的研制具有重要意义。     

酶联免疫吸附试验检测艰难梭菌A毒素

实验用兔单特异抗艰难梭菌Ａ毒素ＩｇＧ包被酶标板,以羊抗艰难梭菌Ａ毒素ＩｇＧ标记辣根过氧化物酶作为第二抗体,采用双抗体夹心ＥＬＩＳＡ法检测艰难梭菌Ａ毒素,可检测出０．９４ｎｇ的精制Ａ毒素,对６１株菌的培养液及６５份健康人粪便标本检测发现此法具有较高的特异性。用平行线定量法对几份典型产毒培养物进行了定量测定,结果表明,在一定剂量范围内线性及平行性好,结果准确、可靠。可用于临床粪便标本中艰难梭菌Ａ毒素的筛查及定量检测。     

艰难梭菌细胞毒素B功能区的克隆及序列分析

目的克隆艰难梭菌(Clostridium difficile,C.d)细胞毒素B羧基末端功能区(CDB3)基因,并对其进行测序及生物信息学分析。方法利用PCR技术扩增CDB3基因,并将其定向插入pET-22b( )载体中,以DNA自动分析仪进行序列测定,并以生物信息学软件分析其生物学特性。结果成功克隆了艰难梭菌CDB3基因,经测序表明与GenBank中分布的Clostridium difficile VPI10463的ToxinB3基因序列完全一致。DNAstar软件预测其蛋白质的相对分子量(Mr)约为71.3 kD,并显示出良好的抗原性。结论研究获得了序列正确的CDB3基因,为其重组表达及其相关研究奠定了良好基础。     

艰难梭菌毒素A原核表达及重组蛋白纯化

目的构建艰难梭菌(Clostridium difficile,C.difficile)毒素A羧基末端原核表达载体,优化诱导表达条件及纯化重组蛋白。方法利用聚合酶链式反应扩增C.difficile毒素A羧基末端基因序列,并将此序列转入pET-28b载体,构建pET-28b-tcdA重组表达载体,并将表达载体转化到BL21(DE3)感受态大肠埃希菌细胞中,分别在不同条件下进行诱导表达,获得最佳诱导表达条件后进行大量表达,最后用Ni柱对重组蛋白进行亲和纯化,得到纯化后的重组蛋白。结果成功构建了pET-28b-tcdA重组表达载体,其重组蛋白表达最佳诱导条件:菌液吸光度值取0.6、温度取25℃、IPTG终浓度取1.0mmol/L、诱导时间取10h。蛋白纯化咪唑磷酸盐洗脱液最佳浓度取200mmol/L。结论成功构建pET-28b-tcdA重组表达载体,在大肠埃希菌BL21(DE3)中可以有效表达,并获得高浓度重组蛋白,为进一步制备TcdA适配子奠定了一定实验室基础。     

艰难梭菌的检验

本文简要述及艰难梭菌毒素A和毒素B检验中的一些问题,着重于A^-B^ 分离菌株的检验,包括细菌培养、毒素的组织培养检定、毒素和共同抗原的酶联免疫吸附试验等,并对检验结果的临床意义进行了分析和讨论。     

住院腹泻患者艰难梭菌快速检测结果分析

目的 了解住院腹泻患者艰难梭菌带菌情况,为抗生素相关腹泻患者的诊断和治疗提供参考。方法 收集2015年9月至2016年8月住院腹泻患者粪便标本163份,用艰难梭菌快速检测试剂盒检测艰难梭菌。结果 艰难梭菌检出总阳性率为20.86%（34/163）,其中春季16.67%、夏季15.79%、秋季17.86%、冬季27.87%,经比较差异无统计学意义（2=2.943,P＞0.05）;成人粪便标本阳性率为22.52%（25/111）,儿童粪便标本阳性率为17.31%（9/52）,差异无统计学意义（2=0.583,P＞0.05）;男性粪便标本阳性率为21.69%（18/83）,女性粪便标本阳性率为20.0%（16/80）,差异无统计学意义（2=0.202,P＞0.05）;艰难梭菌阳性患者抗菌药物平均使用天数为12.74 d,阴性患者为8.21 d,差异有统计学意义（t=－7.81,P＜0.01）。结论 住院腹泻患者艰难梭菌阳性率高低与抗菌药物使用时间长短有关。     

上海部分地区儿童艰难梭菌相关性腹泻的临床分析

本文旨在监测儿童腹泻中艰难梭菌相关性腹泻(CDAD)的发病情况,并对其进行回顾性临床分析。对复旦大学附属儿科医院2007年2月～9月111例腹泻患儿的粪便标本进行艰难梭菌毒素A检测及粪便厌氧菌培养,对所有患儿进行回顾性病史采集及分析,并对粪便培养所得的4株艰难梭菌菌株用多位点可变数目串联重复序列分析(MLVA)技术进行同源性分析。111例患者中,艰难梭菌毒素A检测及艰难梭菌培养均为阳性者无,艰难梭菌毒素A阳性而艰难梭菌培养阴性者16例,艰难梭菌毒素A阴性而艰难梭菌培养阳性者4例,艰难梭菌毒素A及艰难梭菌培养均阴性者91例。比较院内、院外组3种不同病程腹泻CDAD的发病率,无显著差异。MLVA分析发现粪便培养得到的4株艰难梭菌菌株有部分同源性。结果提示,目前上海部分地区儿童CDAD发病情况为散发,但彼此之间有部分同源性;院内、外获得性腹泻的CDAD发病率无显著差异;艰难梭菌毒素A阳性或艰难梭菌培养阳性的病例在临床表现上与艰难梭菌毒素A阴性且艰难梭菌培养阴性的腹泻病例无显著差异。     

123例腹泻患儿粪便中艰难梭菌毒素基因特征及感染危险因素分析

探讨腹泻患儿粪便中艰难梭菌毒素基因特征, 并分析产毒艰难梭菌感染的危险因素。

采集2019年1月至2021年3月嘉兴市第二医院儿科收治的腹泻患儿的粪便标本共123份, 其中社区获得性腹泻患儿60例, 医院获得性腹泻患儿63例。标本进行厌氧培养, 采用实时荧光PCR鉴定艰难梭菌tpi基因, 并检测tcd A、tcd B毒素基因。收集患儿临床资料, 采用Logistic回归分析产毒艰难梭菌感染的危险因素。

123例粪便标本共检出艰难梭菌tpi基因阳性35例(28.46%), 毒素基因中tcd A⁺ B⁺为19例(15.45%), tcd A⁺B^-为3例(2.44%), tcd A^-B⁺为2例(1.63%), tcd A^-B^-为11例(8.94%)。社区获得性腹泻患儿中tcd A/B产毒艰难梭菌感染率为28.33%, 高于医院获得性腹泻患儿的11.11%(P < 0.05)。产毒艰难梭菌感染腹泻患儿与非产毒艰难梭菌感染腹泻患儿的性别、年龄、居住地、是否早产、有无先天性疾病、既往有无胃肠道手术、抗生素应用种类、近1个月内有无机械通气、临床症状、血液白细胞计数、血红蛋白、粪便白细胞计数、血清C反应蛋白、血清白细胞介素-6、血清白蛋白、血肌酐、血清总胆红素水平比较差异无统计学意义(均P > 0.05)。产毒艰难梭菌感染腹泻患儿中的非母乳喂养、近1个月内抗生素用药史、抗生素持续用药时间 > 7 d、近1个月内糖皮质激素用药史、近1个月内抑酸药用药史、近1个月内肠内营养者的比例显著高于非产毒艰难梭菌感染腹泻患儿(均P < 0.05)。非母乳喂养(OR=2.433)、近1个月内抗生素用药史(OR=3.040)、近1个月内肠内营养(OR=2.330)是腹泻患儿产毒艰难梭菌感染的独立危险因素(均P < 0.05)。

嘉兴地区儿童艰难梭菌毒素基因主要为tcd A/B基因, 患儿以社区获得性腹泻为主, 非母乳喂养、抗生素用药史、肠内营养的儿童更容易感染艰难梭菌。

     

兰州地区腹泻患者艰难梭菌的感染状况调查

目的调查兰州地区腹泻患者中艰难梭菌的流行特点,揭示国内艰难梭菌感染的现况。方法通过细胞毒检测试验和酶联免疫吸附试验对206份临床粪便样品进行毒素检测。结果 206份粪便滤液经细胞毒检测有26份样品使非洲绿猴肾细胞（vero细胞）圆缩化,确认含有艰难梭菌毒素;经酶联免疫吸附试验有28份为阳性,其中23份与细胞毒检测结果一致,与细胞毒试验的符合率为88.5%。结论兰州地区住院腹泻患者中艰难梭菌感染率约为12.62%。     

Clostridium difficile toxins A and B: Receptors,pores, and translocation into cells

The most potent toxins secreted by pathogenic bacteria contain enzymatic moieties that must reach the cytosol of target cells to exert their full toxicity. Toxins such as anthrax, diphtheria, and botulinum toxin all use three well-defined functional domains to intoxicate cells: a receptor-binding moiety that triggers endocytosis into acidified vesicles by binding to a specific host-cell receptor, a translocation domain that forms pores across the endosomal membrane in response to acidic pH, and an enzyme that translocates through these pores to catalytically inactivate an essential host cytosolic substrate. The homologous toxins A (TcdA) and Toxin B (TcdB) secreted by Clostridium difficile are large enzyme-containing toxins that for many years have eluded characterization. The cell-surface receptors for these toxins, the non-classical nature of the pores that they form in membranes, and mechanism of translocation have remained undefined, exacerbated, in part, by the lack of any structural information for the central ～1000 amino acid translocation domain. Recent advances in the identification of receptors for TcdB, high-resolution structural information for the translocation domain, and a model for the pore have begun to shed light on the mode-of-action of these toxins. Here, we will review TcdA/TcdB uptake and entry into mammalian cells, with focus on receptor binding, endocytosis, pore formation, and translocation. We will highlight how these toxins diverge from classical models of translocating toxins, and offer our perspective on key unanswered questions for TcdA/TcdB binding and entry into mammalian cells.     

Toxins A and B of Clostridium difficile

Abstract: The toxins produced by Clostridium difficile share several functional properties with other bacterial toxins, like the heat-labile enterotoxin of Escherichia coli and cholera toxin. However, functional and structural differences also exist. Like cholera toxin, their main target is the disruption of the microfilaments in the cell. However, since these effects are not reversible, as found with cholera toxin, additional mechanisms add to the cytotoxic potential of these toxins. Unlike most bacterial toxins, which are built from two structurally and functionally different small polypeptide chains, the functional and binding properties of the toxins of C. difficile are confined within one large polypeptide chain, making them the largest bacterial toxins known so far.     

Heterogeneity of large clostridial toxins: importance of Clostridium difficile toxinotypes

Clostridium difficile toxinotypes are groups of strains defined by changes in the PaLoc region encoding two main virulence factors: toxins TcdA and TcdB. Currently, 24 variant toxinotypes (I-XXIV) are known, in addition to toxinotype 0 strains, which contain a PaLoc identical to the reference strain VPI 10463. Variant toxinotypes can also differ from toxinotype 0 strains in their toxin production pattern. The most-studied variant strains are TcdA-, TcdB+ (A-B+) strains and binary toxin CDT-producing strains. Variations in toxin genes are also conserved on the protein level and variant toxins can differ in size, antibody reactivity, pattern of intracellular targets (small GTPases) and consequently in their effects on the cell. Toxinotypes do not correlate with particular forms of disease or patient populations, but some toxinotypes (IIIb and VIII) are currently associated with disease of increased severity and outbreaks worldwide. Variant toxinotypes are very common in animal hosts and can represent from 40% to 100% of all isolates. Among human isolates, variant toxinotypes usually represent up to 10% of strains but their prevalence is increasing.     

Signal transduction pathways and cellular intoxication with Clostridium difficile toxins

In cultured cells the cytopathic effects (CPE) of Clostridium difficile toxins A and B are superficially similar. The irreversible CPEs involve a reorganization of the cytoskeleton, but the molecular details of the mechanism(s) of action are unknown. As part of the work to elucidate the events leading to the CPE, cultured cells were preincubated with agents known to either stimulate or inhibit some major signal transduction pathways, whereupon toxin was added and the development of the CPE was followed. Both toxin-induced CPEs were enhanced by phorbol esters and mezerein, which stimulate protein kinase C, while they were inhibited by the phospholipase A2 inhibitors quinacrine and 4-bromophenacylbromide. Agents affecting certain G-proteins, cGMP and cAMP levels, phosphatases, prostacyclin, lipoxygenase, and phospholipase C did not affect the development of the CPE of either toxin. Thus, the cytoskeletal effect induced by toxins A or B appears to require PLA2 activity and involves at least part of a protein kinase C-dependent pathway, but not pertussis toxin-sensitive G-proteins, cyclic nucleotides, eicosanoid metabolites, or phospholipase C activity. In addition, both toxins were shown to activate phospholipase A2.     

Evaluation of the proposed interaction of nucleic acid with Clostridium difficile toxins A and B and the effects of nucleases on cytotoxicity

Both DNA and RNA were found to co-purify with Clostridium difficile toxin B but not toxin A. DNAase treatment greatly reduced the cytotoxicity of toxin B but not of toxin A. RNAase had no effect on either toxin. The effects on toxin B were shown to be due to a contaminating protease and could be inhibited by the serine protease inhibitor phenylmethylsulphonyl fluoride.     

Detection of toxin B of Clostridium difficile based on immunomagnetic separation and aptamer-mediated colorimetric assay

Clostridium difficile can cause antibiotic-associated diarrhoea or pseudo-membranous colitis in humans and animals. Currently, the various methods such as microbiological culture, cytotoxic assay, ELISA and polymerase chain reaction have been used to detect Clostridium difficile infection (CDI). These conventional methods, however, require long detection time and professional staff. The paper is to describe a simple strategy which employs immunomagnetic separation and aptamer-mediated colorimetric assay for the detection of toxin B of C. difficile (TcdB) in the stool samples. HRP-labelled aptamer against TcdB selected by SELEX was firstly captured on the surface of magnetic beads (MB) by DNA hybridization with a complementary strand. In the presence of TcdB, aptamer specifically recognized and bound TcdB, disturbing the DNA hybridization and causing the release of HRP-aptamer from MB. This reduced the catalytic capacity of HRP and consequently the absorption intensity. As there was a relationship between the decrease in the absorption intensity and target concentration, a quantitative analysis of TcdB can be accomplished by the measurement of the absorption intensity. Under the optimal conditions, the assay system is able to detect TcdB at a concentration down to 5 ng ml⁻¹. Moreover the method had specificity of 97% and sensitivity of 66% and the system remained excellent stability within 4 weeks. The proposed method is a valuable screening procedure for CDI and can be extended readily to detection of other clinically important pathogens.     

Detection of the ADP-ribosyltransferase toxin gene (cdtA) and its activity in Clostridium difficile isolates from Equidae

Clostridium difficile is an antibiotic-associated emerging pathogen of humans and animals. Thus far three toxins of C. difficile have been described: an enterotoxin (ToxA), a cytotoxin (ToxB) and an ADP-ribosyltransferase (CDT). In the present work we describe the first isolation of CDT producing C. difficile from Equidae with gastro-intestinal disease. Out of 17 C. difficile strains isolated from Equidae, 11 were positive for the genes tcdA and tcdB encoding ToxA and ToxB. In addition four of these 11 isolates were positive for the cdtA gene encoding the catalytic subunit of the ADP-ribosyltransferase CDT. Interestingly none of the isolates derived from canines (41 isolates) and felines (4 isolates) harboured the cdtA gene. In C. difficile field isolates which contained the cdtA gene, ADP-ribosyltransferase activity could also be detected in culture supernatants indicating expression and secretion of CDT. All strains were associated with intestinal disorders, but no association was found for the occurrence of toxins with a specific clinical diagnosis.