title: Effect of biotherapeutics on antitoxin IgG in experimentally induced Clostridium difficile infection.
abstract: OBJECTIVE
  Recurrent diarrhoea after successful treatment of primary Clostridium difficile associated disease (CDAD) occurs due to bowel flora alterations and failure to mount an effective antibody response. Apart from antibiotics, risk factors include immunosuppressive and acid-suppressive drug administration. Biotherapeutics such as probiotic and epidermal growth factor (EGF) may offer potential effective therapy for CDAD.
  
  
  METHODS
  The effect of biotherapeutics in mounting an antibody response against C. difficile toxins was studied in BALB/c mice challenged with C. difficile after pre-treatment with ampicillin, lansoprazole or cyclosporin. Sera from sacrificed animals were estimated for antitoxin IgG by enzyme linked immunosorbent assay.
  
  
  RESULTS
  Antitoxin IgG was significantly higher (P<0.05) in C. difficile challenged groups compared to unchallenged controls, but insignificant (P>0.05) in animals in which C. difficile was given after pre-treatment with cyclosporin compared to those without any pre-treatment, or pre-treatment with antibiotic or lansoprazole. In inter-subgroup comparisons also significant anomaly in production of antitoxin IgG was found. The antitoxin IgG levels were raised in animals administered C. difficile after pre-treatment with ampicillin, but lower in animals administered cyclosporin. High levels of antitoxin IgG were also found in the serum samples of animals receiving lansoprazole and C. difficile.
  
  
  CONCLUSIONS
  Probiotics showed their beneficial effect by boosting the immune response as seen by production of antitoxin IgG. Oral administration of EGF did not affect the immune response to C. difficile toxins as significant increase was not observed in the serum antitoxin IgG levels in any of the groups investigated.
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Kaur
authors.forename: C
authors.initials: C
authors.lastname: Vaishnavi
authors.forename: R
authors.initials: R
authors.lastname: Kochhar
authors.forename: K K
authors.initials: KK
authors.lastname: Prasad
authors.forename: P
authors.initials: P
authors.lastname: Ray
mesh_terms: D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D000992:Antitoxins / Q000097:blood*; D016360:Clostridioides difficile / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000188:drug therapy*; D004195:Disease Models, Animal; D004815:Epidermal Growth Factor / Q000008:administration & dosage*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007155:Immunologic Factors / Q000008:administration & dosage; D051379:Mice; D008807:Mice, Inbred BALB C; D019936:Probiotics / Q000008:administration & dosage*
chemical_list: D000907:Antibodies, Bacterial; D000992:Antitoxins; D007074:Immunoglobulin G; D007155:Immunologic Factors; D004815:Epidermal Growth Factor