title: Passive and active immunization strategies against Clostridium difficile infections: state of the art.
abstract: The pathophysiology of Clostridium difficile infections (CDI) could be considered as a three-step process that takes place after disruption of the digestive microbiota by antibiotics: 1) germination of spores; 2) multiplication and persistence of C. difficile in the colonic niche thanks to colonization factors; 3) production of the two toxins TcdA and TcdB and for some strains an additional toxin, the binary toxin CDT. Different immunization strategies against C. difficile have been developed, first regarding the toxins. Immunization assays with colonization factors have followed, and allowed accumulation of new data concerning theirs functions and immunogenicity. Here, we present the toxins, the colonization factors and their use in passive and active immunizations to treat and/or to prevent C. difficile infections. The various experiments performed in animal models and the first clinical trials in humans are reported.
authors: EA 4043, Faculté de pharmacie, Université Paris-Sud, 5 rue Jean Baptiste Clément, 92296 Chatenay-Malabry Cedex, France.
authors: Assaf
authors: A
authors: Mizrahi
authors: EA 4043, Faculté de pharmacie, Université Paris-Sud, 5 rue Jean Baptiste Clément, 92296 Chatenay-Malabry Cedex, France. Electronic address: anne.collignon@u-psud.fr.
authors: Anne
authors: A
authors: Collignon
authors: EA 4043, Faculté de pharmacie, Université Paris-Sud, 5 rue Jean Baptiste Clément, 92296 Chatenay-Malabry Cedex, France. Electronic address: severine.pechine@u-psud.fr.
authors: Séverine
authors: S
authors: Péchiné
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D016360:Clostridioides difficile / Q000276:immunology*; D003015:Clostridium Infections / Q000276:immunology / Q000517:prevention & control*; D004353:Drug Evaluation, Preclinical; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D014611:Vaccination / Q000379:methods*
keywords: Clostridium difficile; Colonization factors; Passive and active immunization; Toxins