|
| ||
|
|
||
C. Difficile Toxin (c + difficile_toxin)
Selected AbstractsReview article: anti-inflammatory mechanisms of action of Saccharomyces boulardiiALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2009C. POTHOULAKIS Aliment Pharmacol Ther,30, 826,833 Summary Background,Saccharomyces boulardii, a well-studied probiotic, can be effective in inflammatory gastrointestinal diseases with diverse pathophysiology, such as inflammatory bowel disease (IBD), and bacterially mediated or enterotoxin-mediated diarrhoea and inflammation. Aim, To discuss the mechanisms of action involved in the intestinal anti-inflammatory action of S. boulardii. Methods, Review of the literature related to the anti-inflammatory effects of this probiotic. Results, Several mechanisms of action have been identified directed against the host and pathogenic microorganisms. S. boulardii and S. boulardii secreted-protein(s) inhibit production of proinflammatory cytokines by interfering with the global mediator of inflammation nuclear factor ,B, and modulating the activity of the mitogen-activated protein kinases ERK1/2 and p38. S. boulardii activates expression of peroxisome proliferator-activated receptor-gamma (PPAR-,) that protects from gut inflammation and IBD. S. boulardii also suppresses ,bacteria overgrowth' and host cell adherence, releases a protease that cleaves C. difficile toxin A and its intestinal receptor and stimulates antibody production against toxin A. Recent results indicate that S. boulardii may interfere with IBD pathogenesis by trapping T cells in mesenteric lymph nodes. Conclusions, The multiple anti-inflammatory mechanisms exerted by S. boulardii provide molecular explanations supporting its effectiveness in intestinal inflammatory states. [source] Failure of dietary oligofructose to prevent antibiotic-associated diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2005S. Lewis Summary Background :,Oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. High bifidobacteria concentrations are important in providing ,colonization resistance' against pathogenic bacteria. Aim :,To reduce the incidence of antibiotic-associated diarrhoea in elderly patients. Methods :,Patients over the age of 65 taking broad-spectrum antibiotics received either oligofructose or placebo. A baseline stool sample was cultured for Clostridium difficile and tested for C. difficile toxin. A further stool sample was analysed for C. difficile if diarrhoea developed. Results :,No difference was seen in the baseline characteristics, incidence of diarrhoea, C. difficile infection or hospital stay between the two groups (n = 435). Oligofructose increased bifidobacterial concentrations (P < 0.001, 95% CI: 0.69,1.72). A total of 116 (27%) patients developed diarrhoea of which 49 (11%) were C. difficile -positive and were more likely to be taking a cephalosporin (P = 0.006), be female (P < 0.001), to have lost more weight (P < 0.001, 95% CI: 0.99,2.00) and stayed longer in hospital (P < 0.001, 95% CI: 0.10,1.40). Amoxicillin (amoxycillin) and clavulanic acid increased diarrhoea not caused by C. difficile (P = 0.006). Conclusion :,Oligofructose does not protect elderly patients receiving broad-spectrum antibiotics from antibiotic-associated diarrhoea whether caused by C. difficile or not. Oligofructose was well-tolerated and increased faecal bifidobacterial concentrations. [source] Evaluation of in vitro properties of di-tri-octahedral smectite on clostridial toxins and growthEQUINE VETERINARY JOURNAL, Issue 7 2003J. S. Weese Summary Reasons for performing study: Clostridial colitis and endotoxaemia of intestinal origin are significant causes of morbidity and mortality in horses. Intestinal adsorbents are available for treatment of these conditions; however, little information exists supporting their use. Objectives: To evaluate the ability of di-tri-octahedral smectite to bind to Clostridium difficile toxins A and B, C. perfringens enterotoxin and endotoxin, inhibit clostridial growth and the actions of metronidazole in vitro. Methods: Clostridium difficile toxins, C. perfringens enterotoxin and endotoxin were mixed with serial dilutions of di-tri-octahedral smectite, then tested for the presence of clostridial toxins or endotoxin using commercial tests. Serial dilutions of smectite were tested for the ability to inhibit growth of C. perfringens in culture broth, and to interfere with the effect of metronidazole on growth of C. perfringens in culture broth. Results: Clostridium difficile toxins A and B, and C. perfringens enterotoxin were completely bound at dilutions of 1:2 to 1:16. Partial binding of C. difficile toxins occurred at dilutions up to 1:256 while partial binding of C. perfringens enterotoxin occurred up to a dilution of 1:128. Greater than 99% binding of endotoxin occurred with dilutions 1:2 to 1:32. No inhibition of growth of C. difficile or C. perfringens was present at any dilution, and there was no effect on the action of metronidazole. Conclusions: Di-tri-octahedral smectite possesses the ability to bind C. difficile toxins A and B, C. perfringens enterotoxin and endotoxin in vivo while having no effect on bacterial growth or the action of metronidazole. Potential relevance: In vivo studies are required to determine whether di-tri-octahedral smectite might be a useful adjunctive treatment of clostridial colifis and endotoxaemia in horses. [source] Proton pump inhibitors as a risk factor for paediatric Clostridium difficile infectionALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2010R. TURCO Aliment Pharmacol Ther,31, 754,759 Summary Background, Proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) may play an important role on the onset of Clostridium difficile -associated disease (CDAD) in adults. The impact of Clostridium difficile on children treated with gastric acid-suppressing agents remains unknown. Aim, To investigate the relationship between CDAD and exposure to acid suppressive therapy in hospitalized paediatric patients. Methods, We reviewed the medical records of children, with a diagnosis of protracted diarrhoea and abdominal pain, whose stool was analysed for C. difficile toxins. We identified 68 patients with CDAD. For each patient, we randomly selected one control subjects with stool analysis negative for C. difficile. Comorbid illnesses, previous hospitalizations, antibiotics, corticosteroids, immunosuppressants and gastric acid suppressing exposures were recorded. Results, The use of PPI was significantly higher in C. difficile positive group compared with C. difficile negative group [odds ratio (OR): = 4.5; 95% confidence interval (CI) = 1.4,14.4]. We also found a trend for the use of H2RAs in patients infected by C. difficile compared with C. difficile negative comparison group (OR: = 3.8; 95% CI = 0.7,18.9). Conclusions, Children exposed to PPIs therapy seem to be at higher risk for the development of Clostridium difficile -associated disease. [source] | ||||||||||