Virulence Factors

毒力因子
  • 文章类型: Journal Article
    鼠疫Riemerella是一种引起鸭浆膜炎和脑膜炎的致病菌,对养鸭业造成重大危害。为了逃离宿主免疫系统,引起脑膜炎的细菌必须在血液中存活和繁殖,依赖于特定的毒力因子,如胶囊。因此,研究与厌食R.anatipestifer胶囊生物合成有关的基因至关重要。在这项研究中,我们成功构建了针对GE296_RS03820和GE296_RS03830基因的基因缺失突变体Δ3820和Δ3830,分别,使用RA-LZ01菌株作为亲本菌株。生长动力学分析表明,这两个基因有助于细菌生长。透射和扫描电子显微镜(TEM和SEM)以及银染表明,Δ3820和Δ3830产生了改变的胶囊和荚膜多糖(CPS)化合物。血清抗性测试显示突变体还表现出减少的C3b沉积和减少的抗性血清杀伤。在体内,Δ3820和Δ3830显示出穿过血脑屏障的能力明显下降,与RA-LZ01相比。这些发现表明,GE296_RS03820和GE296_RS03830基因参与CPSs的生物合成,并在抗药性R.anatipestifer的致病性中起关键作用。此外,Δ3820和Δ3830突变体在体内表现出更高的RA-LZ01攻击存活率的趋势。此外,用突变体免疫的鸭血清显示出与不同血清型的R.anatipestifer的交叉免疫反应性,包括1、2、7和10。Western印迹和SDS-PAGE测定表明,Δ3820和Δ3830的CPS改变导致一些保守蛋白的暴露在交叉免疫反应中起关键作用。我们的研究清楚地表明,GE296_RS03820和GE296_RS03830基因参与了厌食R.anatipestifer中的CPS生物合成,并且胶囊是疫苗开发中减毒的目标。
    Riemerella anatipestifer is a pathogenic bacterium that causes duck serositis and meningitis, leading to significant harm to the duck industry. To escape from the host immune system, the meningitis-causing bacteria must survive and multiply in the bloodstream, relying on specific virulence factors such as capsules. Therefore, it is essential to study the genes involved in capsule biosynthesis in R. anatipestifer. In this study, we successfully constructed gene deletion mutants Δ3820 and Δ3830, targeting the GE296_RS03820 and GE296_RS03830 genes, respectively, using the RA-LZ01 strain as the parental strain. The growth kinetics analysis revealed that these two genes contribute to bacterial growth. Transmission and scanning electron microscopy (TEM and SEM) and silver staining showed that Δ3820 and Δ3830 produced the altered capsules and compounds of capsular polysaccharides (CPSs). Serum resistance test showed the mutants also exhibited reduced C3b deposition and decreased resistance serum killing. In vivo, Δ3820 and Δ3830 exhibited markedly declining capacity to cross the blood-brain barrier, compared to RA-LZ01. These findings indicate that the GE296_RS03820 and GE296_RS03830 genes are involved in CPSs biosynthesis and play a key role in the pathogenicity of R. anatipestifer. Furthermore, Δ3820 and Δ3830 mutants presented a tendency toward higher survival rates from RA-LZ01 challenge in vivo. Additionally, sera from ducklings immunized with the mutants showed cross-immunoreactivity with different serotypes of R. anatipestifer, including 1, 2, 7 and 10. Western blot and SDS-PAGE assays revealed that the altered CPSs of Δ3820 and Δ3830 resulted in the exposure of some conserved proteins playing the key role in the cross-immunoreactivity. Our study clearly demonstrated that the GE296_RS03820 and GE296_RS03830 genes are involved in CPS biosynthesis in R. anatipestifer and the capsule is a target for attenuation in vaccine development.
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  • 文章类型: Journal Article
    肺炎链球菌感染是一个主要的公共卫生问题,发病率和死亡率都很高。本研究旨在评估血清型分布,抗菌素耐药性的变化,克隆组合物,2000年至2021年中国东北地区肺炎链球菌分离株的毒力因子。共纳入1,454株肺炎链球菌分离株,有568个侵袭性菌株和886个非侵袭性菌株。分离肺炎链球菌的患者年龄从26天到95岁不等,≤5岁的人群占最大组(67.19%)。19F,19A,23F,14和6B是最常见的血清型,其中19A和19F是侵袭性和非侵袭性肺炎链球菌的主要血清型,分别。CC271是最常见的多位点序列类型。血清型14有最低的cbpA的表达,rrgA,和psrP基因,但19A和19F基因的表达水平相似。所有分离株对厄他培南敏感,莫西沙星,利奈唑胺,和万古霉素,但对大环内酯类药物具有高度抗性,四环素,和复方新诺明。同时对红霉素耐药,克林霉素,四环素,甲氧苄啶/磺胺甲恶唑是多重耐药分离株中的常见模式。非侵袭性肺炎链球菌对β-内酰胺类抗生素的耐药性高于侵袭性菌株。19A和19F是耐青霉素肺炎链球菌的主要菌株。与前一时期相比,2017年至2021年β-内酰胺类抗生素的耐药率下降。将PCV13纳入国家免疫规划可以有效降低肺炎球菌病的发病率和死亡率。
    Streptococcus pneumoniae infection is a major public health concern with high morbidity and mortality rates. This study aimed to evaluate the serotype distribution, antimicrobial resistance changes, clonal composition, and virulence factors of S. pneumoniae isolates causing pneumococcal disease in northeast China from 2000 to 2021. A total of 1,454 S. pneumoniae isolates were included, with 568 invasive strains and 886 non-invasive strains. The patients from whom the S. pneumoniae were isolated ranged in age from 26 days to 95 years, with those ≤ 5 years old comprising the largest group (67.19%). 19 F, 19 A, 23 F, 14, and 6B were the most common serotypes, of which 19 A and 19 F were the main serotypes of invasive and non-invasive S. pneumoniae, respectively. CC271 was the most common multilocus sequence type. Serotype 14 had the lowest expression of cbpA, rrgA, and psrP genes, but expression levels of 19 A and 19 F genes were similar. All isolates were sensitive to ertapenem, moxifloxacin, linezolid, and vancomycin but highly resistant to macrolides, tetracyclines, and cotrimoxazole. Simultaneous resistance to erythromycin, clindamycin, tetracyclines, and trimethoprim/sulfamethoxazole was common pattern among multidrug-resistant isolates. Non-invasive S. pneumoniae had higher resistance to β-lactam antibiotics than invasive strains. 19 A and 19 F were the main strains of penicillin-resistant S. pneumoniae. The resistance rate of β-lactam antibiotics decreased from 2017 to 2021 compared to previous periods. Including PCV13 in the national immunization program can reduce the morbidity and mortality rates of pneumococcal disease effectively.
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  • 文章类型: Journal Article
    螺旋虫,属于Mollicutes班,是一个小,螺旋,缺乏细胞壁的能动细菌。它的宿主范围包括昆虫,植物,和水生甲壳类动物。最近,已经报道了一些人感染螺旋体的病例。螺旋虫引起的疾病给农业带来了严重的经济损失,阻碍了农业的健康发展。螺旋体的发病机制涉及粘附能力,例如通过螺旋体的末端结构,殖民,和侵入性酶。然而,螺旋体的确切致病机制仍然是个谜。因此,在这篇综述文章中,我们系统地总结了有关螺旋体的所有信息。这为今后研究螺旋体的毒力因子和治疗策略提供了参考。
    Spiroplasma, belonging to the class Mollicutes, is a small, helical, motile bacterium lacking a cell wall. Its host range includes insects, plants, and aquatic crustaceans. Recently, a few human cases of Spiroplasma infection have been reported. The diseases caused by Spiroplasma have brought about serious economic losses and hindered the healthy development of agriculture. The pathogenesis of Spiroplasma involves the ability to adhere, such as through the terminal structure of Spiroplasma, colonization, and invasive enzymes. However, the exact pathogenic mechanism of Spiroplasma remains a mystery. Therefore, we systematically summarize all the information about Spiroplasma in this review article. This provides a reference for future studies on virulence factors and treatment strategies of Spiroplasma.
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  • 文章类型: Journal Article
    污泥中的多重耐药细菌和多重耐药基因已成为公共卫生的严重问题。开发可行且环境友好的污泥堆肥方法来缓解多药耐药基因势在必行。植物精油是一种有效的天然和生态友好的抗菌,在农业中对抑制病原体有很大的利用。然而,植物精油在堆肥中控制病原菌和抗生素抗性的应用尚未见报道。这项研究通过添加植物来源的精油进行了堆肥系统,即牛至精油(OEO),污泥堆肥。研究结果表明,多药耐药基因和优先病原体(关键,高,与对照组相比,添加OEO(OH处理)和中等类别)降低了(17.0±2.2)%和(26.5±3.0)%。此外,OH处理改变了堆肥微生物中细菌群落并增强了与碳水化合物代谢相关的基因序列。Mantel检验和变异划分分析表明,目标毒力因子(VFs),目标移动遗传元件(MGEs),和优先病原菌是影响堆肥多药耐药性的最重要因素。OH处理能显著抑制靶VFs,目标MGE,和优先病原体,有助于抑制和消除多药耐药基因。这些发现为污泥堆肥过程中多药耐药基因的调控提供了新的见解,并为降低抗生素耐药性的环境风险提供了新的途径。
    Multidrug-resistant bacteria and multi-resistance genes in sludge have become a serious issue for public health. It is imperative to develop feasible and environmentally friendly methods of sludge composting to alleviate multidrug resistance genes. Plant-derived essential oil is an effective natural and eco-friendly antibacterial, which has great utilization in inhibiting pathogens in the agricultural industry. Nevertheless, the application of plant-derived essential oil to control pathogenic bacteria and antibiotic resistance in composting has not been reported. This study conducted a composting system by adding plant-derived essential oil i.e., oregano essential oil (OEO), to sludge composting. The findings indicated that multidrug resistance genes and priority pathogens (critical, high, and medium categories) were reduced by (17.0 ± 2.2)% and (26.5 ± 3.0)% in the addition of OEO (OH treatment) compared to control. Besides, the OH treatment changed the bacterial community and enhanced the gene sequences related to carbohydrate metabolism in compost microorganisms. Mantel test and variation partitioning analysis revealed that the target virulence factors (VFs), target mobile genetic elements (MGEs), and priority pathogens were the most important factors affecting multidrug resistance in composting. The OH treatment could significantly inhibit the target VFs, target MGEs, and priority pathogens, which were helpful for the suppression and elimination of multidrug resistance genes. These findings provide new insights into the regulation of multidrug resistance genes during sludge composting and a novel way to diminish the environmental risk of antibiotic resistance.
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  • 文章类型: Journal Article
    SakazakiiCronobacter,机会食源性病原体,可能会污染各种食物材料,并导致婴儿出现危及生命的症状。细菌包膜结构有助于细菌环境耐受性,革兰氏阴性细菌中各种生物膜的形成和毒力。DsbA和PepP是与细菌包膜生物发生和稳固性有关的两个重要基因。在这项研究中,在Sakazakii中删除DsbA和PepP,以评估它们对病原体的胁迫耐受性和毒力的贡献。细菌环境抗性分析显示,DsbA和PepP在控制不同培养基中对热和干燥的影响是必不可少的。以及酸,渗透,氧化和胆汁盐应激。DsbA和PepP在调节生物膜形成和运动方面也起着重要作用。此外,DsbA和PepP缺失削弱了Caco-2中的Sakazakii粘附和侵袭、RAW264.7中的细胞内存活和复制。qRT-PCR结果表明,Sakazakii的DsbA和PepP在调节环境胁迫耐受性相关基因的表达中起作用,生物膜的形成,细菌运动和细胞入侵。这些发现表明,DsbA和PepP在环境抗性中起着重要的调节作用,Sakazakii的生物膜形成和毒力,这丰富了对病原体适应性和毒力的遗传决定因素的理解。
    Cronobacter sakazakii, an opportunity foodborne pathogen, could contaminate a broad range of food materials and cause life-threatening symptoms in infants. The bacterial envelope structure contribute to bacterial environment tolerance, biofilm formation and virulence in various in Gram-negative bacteria. DsbA and PepP are two important genes related to the biogenesis and stability of bacterial envelope. In this study, the DsbA and PepP were deleted in C. sakazakii to evaluate their contribution to stress tolerance and virulence of the pathogen. The bacterial environment resistance assays showed DsbA and PepP are essential in controlling C. sakazakii resistance to heat and desiccation in different mediums, as well as acid, osmotic, oxidation and bile salt stresses. DsbA and PepP also played an important role in regulating biofilm formation and motility. Furthermore, DsbA and PepP deletion weaken C. sakazakii adhesion and invasion in Caco-2, intracellular survival and replication in RAW 264.7. qRT-PCR results showed that DsbA and PepP of C. sakazakii played roles in regulating the expression of several genes associated with environment stress tolerance, biofilm formation, bacterial motility and cellular invasion. These findings indicate that DsbA and PepP played an important regulatory role in the environment resisitance, biofilm formation and virulence of C. sakazakii, which enrich understanding of genetic determinants of adaptability and virulence of the pathogen.
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  • 文章类型: Journal Article
    非洲猪瘟(ASF)是一种急性,出血性,由非洲猪瘟病毒(ASFV)引起的猪的高度传染性疾病。我们先前的研究确定ASFVMGF300-2R蛋白作为毒力因子起作用,并发现MGF300-2R通过选择性自噬降解IKKβ。然而,在自噬降解过程中负责IKKβ泛素化的E3泛素连接酶仍然未知。为了解决这个问题,我们首先通过免疫沉淀-质谱法提取了328种与MGF300-2R相互作用的蛋白质。接下来,我们分析并证实了E3泛素连接酶TRIM21和MGF300-2R之间的相互作用,并证明了TRIM21在IKKβ泛素化中的催化作用。最后,我们表明MGF300-2R对IKKβ的降解依赖于TRIM21。总之,我们的结果表明TRIM21是参与MGF300-2R降解IKKβ的E3泛素连接酶,从而增强我们对MGF300-2R功能的理解,并提供对减毒活疫苗的合理设计和针对ASF的抗病毒策略的见解。
    African swine fever (ASF) is an acute, hemorrhagic, highly contagious disease in pigs caused by African swine fever virus (ASFV). Our previous study identified that the ASFV MGF300-2R protein functions as a virulence factor and found that MGF300-2R degrades IKKβ via selective autophagy. However, the E3 ubiquitin ligase responsible for IKKβ ubiquitination during autophagic degradation still remains unknown. In order to solve this problem, we first pulled down 328 proteins interacting with MGF300-2R through immunoprecipitation-mass spectrometry. Next, we analyzed and confirmed the interaction between the E3 ubiquitin ligase TRIM21 and MGF300-2R and demonstrated the catalytic role of TRIM21 in IKKβ ubiquitination. Finally, we indicated that the degradation of IKKβ by MGF300-2R was dependent on TRIM21. In summary, our results indicate TRIM21 is the E3 ubiquitin ligase involved in the degradation of IKKβ by MGF300-2R, thereby augmenting our understanding of the functions of MGF300-2R and offering insights into the rational design of live attenuated vaccines and antiviral strategies against ASF.
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  • 文章类型: Journal Article
    肠道微生物群是在肠道健康和疾病状况中起关键作用的微生物。考虑到肠道微生物群的特征功能,在这项研究中,罗伊氏乳杆菌TPC32(L.罗伊特TPC32)被分离和鉴定,并通过IlluminaMiSeq测序平台分析其全基因组。结果表明,罗伊乳杆菌TPC32对酸和胆汁盐具有较高的抗性,具有良好的体外抗菌能力。因此,罗伊氏乳杆菌TPC32的基因组序列的总长度为2,214,495个碱基对,鸟嘌呤-胞嘧啶含量为38.81%。基于代谢注释,在2,212个蛋白质编码基因中,118和101注解碳水化合物代谢和辅因子和维生素的代谢,分别。同样,使用综合抗生素研究数据库(CARD)和毒力因子数据库(VFDB)注释耐药性和毒力基因,其中vatE和tetW耐药基因在罗伊氏乳杆菌TPC32中被注释,而毒力基因未被注释。罗伊氏乳杆菌TPC32的早期预防减少了鼠伤寒沙门氏菌(S.鼠伤寒)在小鼠中的感染。结果表明,罗伊乳杆菌TPC32能提高血清IgM,减少肠道细胞因子分泌,缓解肠道细胞因子风暴,通过提高sIgA表达来增强肠道生化屏障功能,加强肠道物理屏障功能。同时,基于16SrRNA分析,罗伊氏乳杆菌TPC32结果影响肠道微生物群从疾病状态的恢复并促进有益细菌的繁殖。这些结果为罗伊氏乳杆菌TPC32治疗肠道炎症的生物学功能和治疗潜力提供了新的见解。
    Gut microbiota are the microbial organisms that play a pivotal role in intestinal health and during disease conditions. Keeping in view the characteristic functions of gut microbiota, in this study, Lactobacillus reuteri TPC32 (L. reuteri TPC32) was isolated and identified, and its whole genome was analyzed by the Illumina MiSeq sequencing platform. The results revealed that L. reuteri TPC32 had high resistance against acid and bile salts with fine in vitro antibacterial ability. Accordingly, a genome sequence of L. reuteri TPC32 has a total length of 2,214,495 base pairs with a guanine-cytosine content of 38.81%. Based on metabolic annotation, out of 2,212 protein-encoding genes, 118 and 101 were annotated to carbohydrate metabolism and metabolism of cofactors and vitamins, respectively. Similarly, drug-resistance and virulence genes were annotated using the comprehensive antibiotic research database (CARD) and the virulence factor database (VFDB), in which vatE and tetW drug-resistance genes were annotated in L. reuteri TPC32, while virulence genes are not annotated. The early prevention of L. reuteri TPC32 reduced the Salmonella typhimurium (S. Typhimurium) infection in mice. The results show that L. reuteri TPC32 could improve the serum IgM, decrease the intestinal cytokine secretion to relieve intestinal cytokine storm, reinforce the intestinal biochemical barrier function by elevating the sIgA expression, and strengthen the intestinal physical barrier function. Simultaneously, based on the 16S rRNA analysis, the L. reuteri TPC32 results affect the recovery of intestinal microbiota from disease conditions and promote the multiplication of beneficial bacteria. These results provide new insights into the biological functions and therapeutic potential of L. reuteri TPC32 for treating intestinal inflammation.
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  • 文章类型: Journal Article
    白色念珠菌是最常见的人类共生病原体,也是医院真菌感染的重要原因。在白色念珠菌的代谢中,乙醇脱氢酶1(Adh1)是在糖酵解结束时将丙酮酸脱羧产生的乙醛转化为乙醇的重要酶之一。利用酒精发酵的基本过程,Adh1在多种生物现象中起着积极的作用,包括生物膜的形成,不同物种之间的相互作用,耐药性的发展,以及可能引发的胃肠道癌症。此外,白色念珠菌中的Adh1已证明与调节细胞周期有关,应激反应,和各种细胞内状态。此外,Adh1位于细胞外的细胞壁表面,它在组织入侵和宿主免疫反应等过程中发挥作用。通过对ADH1基因结构的分析,表达模式,和基本功能,这篇综述阐明了Adh1与白色念珠菌内各种生物过程之间的复杂联系,强调其对预防的潜在影响,诊断,和念珠菌病的治疗。
    Candida albicans stands as the foremost prevalent human commensal pathogen and a significant contributor to nosocomial fungal infections. In the metabolism of C. albicans, alcohol dehydrogenase 1 (Adh1) is one of the important enzymes that converts acetaldehyde produced by pyruvate decarboxylation into ethanol at the end of glycolysis. Leveraging the foundational processes of alcoholic fermentation, Adh1 plays an active role in multiple biological phenomena, including biofilm formation, interactions between different species, the development of drug resistance, and the potential initiation of gastrointestinal cancer. Additionally, Adh1 within C. albicans has demonstrated associations with regulating the cell cycle, stress responses, and various intracellular states. Furthermore, Adh1 is extracellularly localized on the cell wall surface, where it plays roles in processes such as tissue invasion and host immune responses. Drawing from an analysis of ADH1 gene structure, expression patterns, and fundamental functions, this review elucidates the intricate connections between Adh1 and various biological processes within C. albicans, underscoring its potential implications for the prevention, diagnosis, and treatment of candidiasis.
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  • 文章类型: Journal Article
    β-N-乙酰氨基葡萄糖苷酶(NagZ),胞质氨基葡萄糖苷酶,在肽聚糖回收中起着举足轻重的作用。先前的研究表明,NagZ基因敲除可显着消除阴沟肠杆菌中AmpC依赖性β-内酰胺的耐药性。然而,NagZ在阴沟大肠杆菌毒力中的作用尚不清楚。我们的研究,纳入小鼠和Galleriamellonella幼虫死亡率的数据,炎症标志物,和组织病理学检查,NagZ敲除后,阴沟肠杆菌的毒力大大降低。转录组测序揭示了NagZ敲除菌株和野生型菌株之间的差异基因表达,特别是在核苷酸代谢途径中。进一步的研究表明,NagZ缺失导致环状单磷酸二鸟苷(c-di-GMP)水平显着增加。此外,转录组测序和RT-qPCR证实了ECL_03795的表达的显着差异,ECL_03795是一种功能未知的基因,但由于其已知的磷酸二酯酶活性的EAL结构域,推测参与c-di-GMP代谢。有趣的是,在ECL_03795敲除菌株中,观察到毒力显着降低,用ECL_03795互补后,毒力得以拯救。因此,我们的研究表明,NagZ对毒力的功能部分是通过ECL_03795→c-di-GMP途径介导的,提供对新疗法开发的洞察力,并强烈支持创建高效NagZ抑制剂的兴趣。
    β-N-acetylglucosaminidase (NagZ), a cytosolic glucosaminidase, plays a pivotal role in peptidoglycan recycling. Previous research demonstrated that NagZ knockout significantly eradicated AmpC-dependent β-lactam resistance in Enterobacter cloacae. However, NagZ\'s role in the virulence of E. cloacae remains unclear. Our study, incorporating data on mouse and Galleria mellonella larval mortality rates, inflammation markers, and histopathological examinations, revealed a substantial reduction in the virulence of E. cloacae following NagZ knockout. Transcriptome sequencing uncovered differential gene expression between NagZ knockout and wild-type strains, particularly in nucleotide metabolism pathways. Further investigation demonstrated that NagZ deletion led to a significant increase in cyclic diguanosine monophosphate (c-di-GMP) levels. Additionally, transcriptome sequencing and RT-qPCR confirmed significant differences in the expression of ECL_03795, a gene with an unknown function but speculated to be involved in c-di-GMP metabolism due to its EAL domain known for phosphodiesterase activity. Interestingly, in ECL_03795 knockout strains, a notable reduction in the virulence was observed, and virulence was rescued upon complementation with ECL_03795. Consequently, our study suggests that NagZ\'s function on virulence is partially mediated through the ECL_03795→c-di-GMP pathway, providing insight into the development of novel therapies and strongly supporting the interest in creating highly efficient NagZ inhibitors.
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  • 文章类型: Journal Article
    由产毒素艰难梭菌引起的艰难梭菌感染(CDI)是抗菌和医疗保健相关腹泻的主要原因。艰难梭菌的致病性依赖于多种毒力因子的协同作用,包括孢子,鞭毛,IV型菌毛(T4P),毒素,和生物膜。孢子使艰难梭菌存活和传播,而诸如鞭毛和T4P的粘附因子允许艰难梭菌在宿主肠中定植并持续存在。随后,艰难梭菌产生毒素TcdA和TcdB,引起伪膜性结肠炎和其他艰难梭菌相关疾病;粘附因子与细胞外基质结合形成生物膜,允许艰难梭菌逃避药物和免疫系统攻击并引起反复感染。环二鸟苷酸(c-di-GMP)是一种几乎无处不在的第二信使,广泛调节形态,毒力因子的表达,艰难梭菌的多种生理过程。在这次审查中,我们总结了目前关于c-di-GMP如何在艰难梭菌中差异调节毒力因子表达和发病机制相关表型的知识.我们强调,艰难梭菌孢子形成和毒素和鞭毛基因的表达在细胞内高水平的c-di-GMP被抑制,而T4P生物合成,细胞聚集,并诱导生物膜形成。最近的研究增强了我们对艰难梭菌中c-di-GMP信号网络的理解,并为开发c-di-GMP依赖性抗CDI策略提供了见解。
    Clostridioides difficile infection (CDI) caused by toxigenic C. difficile is the leading cause of antimicrobial and healthcare-associated diarrhea. The pathogenicity of C. difficile relies on the synergistic effect of multiple virulence factors, including spores, flagella, type IV pili (T4P), toxins, and biofilm. Spores enable survival and transmission of C. difficile, while adhesion factors such as flagella and T4P allow C. difficile to colonize and persist in the host intestine. Subsequently, C. difficile produces the toxins TcdA and TcdB, causing pseudomembranous colitis and other C. difficile-associated diseases; adhesion factors bind to the extracellular matrix to form biofilm, allowing C. difficile to evade drug and immune system attack and cause recurrent infection. Cyclic diguanylate (c-di-GMP) is a near-ubiquitous second messenger that extensively regulates morphology, the expression of virulence factors, and multiple physiological processes in C. difficile. In this review, we summarize current knowledge of how c-di-GMP differentially regulates the expression of virulence factors and pathogenesis-related phenotypes in C. difficile. We highlight that C. difficile spore formation and expression of toxin and flagella genes are inhibited at high intracellular levels of c-di-GMP, while T4P biosynthesis, cell aggregation, and biofilm formation are induced. Recent studies have enhanced our understanding of the c-di-GMP signaling networks in C. difficile and provided insights for the development of c-di-GMP-dependent strategies against CDI.
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