title: Impact of microbial derived secondary bile acids on colonization resistance against Clostridium difficile in the gastrointestinal tract.
abstract: Clostridium difficile is an anaerobic, Gram positive, spore-forming bacillus that is the leading cause of nosocomial gastroenteritis. Clostridium difficile infection (CDI) is associated with increasing morbidity and mortality, consequently posing an urgent threat to public health. Recurrence of CDI after successful treatment with antibiotics is high, thus necessitating discovery of novel therapeutics against this pathogen. Susceptibility to CDI is associated with alterations in the gut microbiota composition and bile acid metabolome, specifically a loss of microbial derived secondary bile acids. This review aims to summarize in vitro, ex vivo, and in vivo studies done by our group and others that demonstrate how secondary bile acids affect the different stages of the C. difficile life cycle. Understanding the dynamic interplay of C. difficile and microbial derived secondary bile acids within the gastrointestinal tract will shed light on how bile acids play a role in colonization resistance against C. difficile. Rational manipulation of secondary bile acids may prove beneficial as a treatment for patients with CDI.
authors.affiliation: Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA. Electronic address: jenessa_winston@ncsu.edu.
authors.forename: Jenessa A
authors.initials: JA
authors.lastname: Winston
authors.affiliation: Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA. Electronic address: cmtherio@ncsu.edu.
authors.forename: Casey M
authors.initials: CM
authors.lastname: Theriot
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000494:pharmacology / Q000502:physiology*; D016360:Clostridioides difficile / Q000187:drug effects / Q000502:physiology*; D004198:Disease Susceptibility; D019008:Drug Resistance, Neoplasm; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000382:microbiology*; D000069196:Gastrointestinal Microbiome; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D001647:Bile Acids and Salts
keywords: Antibiotics; Clostridium difficile; Colonization resistance; Gut microbiota; Secondary bile acids