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首页> 外文期刊>Clinical and Experimental Gastroenterology >High prevalence of subclass-specific binding and neutralizing antibodies against Clostridium difficile toxins in adult cystic fibrosis sera: possible mode of immunoprotection against symptomatic C. difficile infection
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High prevalence of subclass-specific binding and neutralizing antibodies against Clostridium difficile toxins in adult cystic fibrosis sera: possible mode of immunoprotection against symptomatic C. difficile infection

机译：成人囊性纤维化血清中难辨梭状芽孢杆菌毒素的亚类特异性结合和中和抗体的普遍性：可能是针对症状性 C的免疫保护方式。难感性感染

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Objectives: Despite multiple risk factors and a high rate of colonization for Clostridium difficile , the occurrence of C . difficile infection in patients with cystic fibrosis is rare. The aim of this study was to compare the prevalence of binding C . difficile toxin-specific immunoglobulin (Ig)A, IgG and anti-toxin neutralizing antibodies in the sera of adults with cystic fibrosis, symptomatic C . difficile infection (without cystic fibrosis) and healthy controls. Methods: Subclass-specific IgA and IgG responses to highly purified whole C . difficile toxins A and B (toxinotype 0, strain VPI 10463, ribotype 087), toxin B from a C . difficile toxin-B-only expressing strain (CCUG 20309) and precursor form of B fragment of binary toxin, pCDTb, were determined by protein microarray. Neutralizing antibodies to C . difficile toxins A and B were evaluated using a Caco-2 cell-based neutralization assay. Results: Serum IgA anti-toxin A and B levels and neutralizing antibodies against toxin A were significantly higher in adult cystic fibrosis patients (n=16) compared with healthy controls (n=17) and patients with symptomatic C . difficile infection (n=16); p ≤0.05. The same pattern of response prevailed for IgG, except that there was no difference in anti-toxin A IgG levels between the groups. Compared with healthy controls (toxins A and B) and patients with C . difficile infection (toxin A), sera from cystic fibrosis patients exhibited significantly stronger protective anti-toxin neutralizing antibody responses. Conclusion: A superior ability to generate robust humoral immunity to C . difficile toxins in the cystic fibrosis population is likely to confer protection against symptomatic C . difficile infection. This protection may be lost in the post-transplantation setting, where sera monitoring of anti- C . difficile toxin antibody titers may be of clinical value.
机译：目的：尽管艰难梭菌有多种危险因素和高定殖率，但还是发生了C。难于感染的囊性纤维化患者很少。本研究的目的是比较结合C的患病率。难治性毒素性免疫球蛋白（Ig）A，IgG和抗毒素中和抗体在患有囊性纤维化的有症状C成年人血清中的表达。艰难梭菌感染（无囊性纤维化）和健康对照。方法：亚类特异性IgA和IgG对高度纯化的完整C的应答。艰难梭菌毒素A和B（毒素型0，菌株VPI 10463，核糖型087），毒素B来自C。通过蛋白质微阵列测定仅表达难溶毒素B的菌株（CCUG 20309）和二元毒素B片段的前体形式pCDTb。中和C的抗体。使用基于Caco-2细胞的中和测定法评估难溶毒素A和B。结果：成人囊性纤维化患者（n = 16）的血清IgA抗毒素A和B水平以及抗毒素A的中和抗体显着高于健康对照组（n = 17）和有症状C患者。困难感染（n = 16）; p≤0.05。 IgG的反应模式相同，只是各组之间抗毒素A IgG水平没有差异。与健康对照（毒素A和B）和C患者的比较。难治性感染（毒素A），来自囊性纤维化患者的血清表现出明显更强的保护性抗毒素中和抗体反应。结论：产生强大的针对C的体液免疫的能力。囊性纤维化人群中的难治性毒素很可能为有症状的C提供保护。难感染。在移植后的环境中，对C的血清监测可能会失去这种保护。难治性毒素抗体滴度可能具有临床价值。

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