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

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...

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Main Authors: Monaghan, Tanya M., Negm, Ola H., MacKenzie, B., Hamed, Mohamed R., Shone, Clifford C., Humphreys, D.P., Acharya, K. Ravi, Wilcox, Mark H.
Format: Article
Published: Dove Medical Press 2017
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Online Access:https://eprints.nottingham.ac.uk/44230/
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author Monaghan, Tanya M.
Negm, Ola H.
MacKenzie, B.
Hamed, Mohamed R.
Shone, Clifford C.
Humphreys, D.P.
Acharya, K. Ravi
Wilcox, Mark H.
author_facet Monaghan, Tanya M.
Negm, Ola H.
MacKenzie, B.
Hamed, Mohamed R.
Shone, Clifford C.
Humphreys, D.P.
Acharya, K. Ravi
Wilcox, Mark H.
author_sort Monaghan, Tanya M.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-442302020-05-04T18:55:54Z https://eprints.nottingham.ac.uk/44230/ 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 Monaghan, Tanya M. Negm, Ola H. MacKenzie, B. Hamed, Mohamed R. Shone, Clifford C. Humphreys, D.P. Acharya, K. Ravi Wilcox, Mark H. 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. Dove Medical Press 2017-07-19 Article PeerReviewed Monaghan, Tanya M., Negm, Ola H., MacKenzie, B., Hamed, Mohamed R., Shone, Clifford C., Humphreys, D.P., Acharya, K. Ravi and Wilcox, Mark H. (2017) 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. Clinical and Experimental Gastroenterology, 10 . pp. 169-175. ISSN 1178-7023 Clostridium difficile Cystic fibrosis Antibodies https://www.dovepress.com/high-prevalence-of-subclass-specific-binding-and-neutralizing-antibodi-peer-reviewed-article-CEG doi:10.2147/CEG.S133939 doi:10.2147/CEG.S133939
spellingShingle Clostridium difficile
Cystic fibrosis
Antibodies
Monaghan, Tanya M.
Negm, Ola H.
MacKenzie, B.
Hamed, Mohamed R.
Shone, Clifford C.
Humphreys, D.P.
Acharya, K. Ravi
Wilcox, Mark H.
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Clostridium difficile
Cystic fibrosis
Antibodies
url https://eprints.nottingham.ac.uk/44230/
https://eprints.nottingham.ac.uk/44230/
https://eprints.nottingham.ac.uk/44230/