Nonantimicrobial drug targets for Clostridium difficile infections

Future Microbiol. 2017 Sep;12(11):975-985. doi: 10.2217/fmb-2017-0024. Epub 2017 Jul 31.

Abstract

Clostridium difficile infection (CDI) is a major public health problem worldwide. Treatment has become complicated due to the emergence of strains with increased toxigenicity and sporulation rate, together with rampant antibiotics use that disrupts colonization resistance of the colonic microbiota. As a result, there is a critical need for nonantibiotic treatments. Therapies based on inhibiting the toxins, bacterial structures responsible for colonization, virulence and restoration of the gut microbiota are the most important nonantibiotic targets to combat CDI. This report outlines these targets and how they could become the focus of future therapeutic agents. Inhibiting colonization and virulence factors during CDI will disrupt pathogen persistence and decrease exposure to the inflammatory toxins, allowing the immune system to clear the infection.

Keywords: Clostridium difficile nonantibiotic targets; Clostridium difficile nonantibiotic therapy; Clostridium difficile pathogenesis; Clostridium difficile toxins; quorum sensing inhibitors.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Bacterial Proteins / drug effects*
  • Bacterial Proteins / metabolism
  • Bacterial Toxins / metabolism*
  • Clostridioides difficile / drug effects*
  • Clostridioides difficile / pathogenicity
  • Clostridioides difficile / physiology
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / immunology
  • Clostridium Infections / microbiology
  • Gastrointestinal Microbiome
  • Humans
  • Immunotherapy
  • Quorum Sensing / drug effects
  • Quorum Sensing / physiology
  • Virulence
  • Virulence Factors

Substances

  • Anti-Bacterial Agents
  • Antibodies, Monoclonal
  • Bacterial Proteins
  • Bacterial Toxins
  • Virulence Factors