title: Phosphatidylcholine and the intestinal mucus layer: in vitro efficacy against Clostridium difficile-associated polymorphonuclear neutrophil activation.
abstract: BACKGROUND
  Phosphatidylcholine (PC), an important component of intestinal mucus, protects against Clostridium difficile toxin-induced intestinal barrier injury in vitro. Polymorphonuclear neutrophil (PMN) activation may contribute to intestinal injury and systemic toxicity in patients with C. difficile-associated disease. We therefore hypothesized that the intestinal barrier function against C. difficile toxin by exogenous PC would ameliorate PMN activation.
  
  
  METHODS
  Intestinal epithelial cell (IEC) monolayers were cocultured with C. difficile toxin A and/or exogenous PC. Naïve PMNs were cocultured with IEC culture supernatants and PMN activation, and chemotactic potential determined.
  
  
  RESULTS
  PC treatment of IEC abrogated the enhanced PMN activation and chemotactic potential following toxin A exposure (P < .001).
  
  
  CONCLUSIONS
  Exogenous PC ameliorated PMN activation from IECs exposed to C. difficile toxin. Administration of exogenous PC may be a useful adjunctive treatment in severely ill or immunocompromised patients with C. difficile-associated disease.
authors.affiliation: Department of Surgery, 6C University Health Center, 4201 Saint Antoine, Detroit, MI 48201, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Olson
authors.affiliation: Department of Surgery, 6C University Health Center, 4201 Saint Antoine, Detroit, MI 48201, USA. Electronic address: ldiebel@med.wayne.edu.
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Diebel
authors.affiliation: Department of Surgery, 6C University Health Center, 4201 Saint Antoine, Detroit, MI 48201, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Liberati
mesh_terms: D016360:Clostridioides difficile / Q000187:drug effects* / Q000302:isolation & purification; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D019073:HT29 Cells; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects / Q000378:metabolism / Q000382:microbiology*; D009093:Mucus / Q000382:microbiology; D018375:Neutrophil Activation / Q000187:drug effects*; D010713:Phosphatidylcholines / Q000494:pharmacology*
chemical_list: D010713:Phosphatidylcholines
keywords: Chemotaxis; Clostridium difficile; PMN activation; Phosphatidylcholine