The role of the humoral immune response to Clostridium difficile toxins A and B in susceptibility to C. difficile infection: a case-control study

Anaerobe. 2014 Jun:27:82-6. doi: 10.1016/j.anaerobe.2014.03.011. Epub 2014 Apr 5.

Abstract

Antibody levels to Clostridium difficile toxin A (TcdA), but not toxin B (TcdB), have been found to determine risk of C. difficile infection (CDI). Historically, TcdA was thought to be the key virulence factor; however the importance of TcdB in disease is now established. We re-evaluated the role of antibodies to TcdA and TcdB in determining patient susceptibility to CDI in two separate patient cohorts. In contrast to earlier studies, we find that CDI patients have lower pre-existing IgA titres to TcdB, but not TcdA, when compared to control patients. Our findings suggest that mucosal immunity to TcdB may be important in the early stages of infection and identifies a possible target for preventing CDI progression.

Keywords: Case–control study; Clostridium difficile; Humoral immune response; Toxin A (TcdA); Toxin B (TcdB).

MeSH terms

  • ADP Ribose Transferases / immunology*
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / analysis*
  • Antitoxins / analysis*
  • Bacterial Proteins / immunology*
  • Case-Control Studies
  • Clostridium Infections / immunology*
  • Clostridium Infections / prevention & control*
  • Disease Susceptibility*
  • Female
  • Humans
  • Immunity, Mucosal
  • Immunoglobulin A / analysis
  • Male
  • Middle Aged

Substances

  • Antibodies, Bacterial
  • Antitoxins
  • Bacterial Proteins
  • Immunoglobulin A
  • ADP Ribose Transferases
  • actin-specific ADP-ribosyltransferase, Clostridium