Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2023; 29(4): 582-596
Published online Jan 28, 2023. doi: 10.3748/wjg.v29.i4.582
Cytotoxic synergism of Clostridioides difficile toxin B with proinflammatory cytokines in subjects with inflammatory bowel diseases
Gabrio Bassotti, Alessandro Fruganti, Fabrizio Stracci, Pierfrancesco Marconi, Katia Fettucciari
Gabrio Bassotti, Department of Medicine and Surgery, Gastroenterology, Hepatology & Digestive Endoscopy Section University of Perugia Medical School, Piazza Lucio Severi, Perugia 06132, Italy, and Santa Maria della Misericordia Hospital, Gastroenterology & Hepatology Unit Perugia 06156, Italy
Alessandro Fruganti, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica 62024, Italy
Fabrizio Stracci, Medicine and Surgery, Hygiene and Public Health Section, University of Perugia, Perugia 06123, Italy
Pierfrancesco Marconi, Katia Fettucciari, Medicine and Surgery, Biosciences & Medical Embryology Section, University of Perugia, Perugia 06132, Italy
Author contributions: Bassotti G organized the project and contributed to finalizing the draft; Fruganti A, Stracci F, and Marconi P critically revised the manuscript; Fettucciari K wrote the draft and contributed to finalizing it; All authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gabrio Bassotti, MD, PhD, Associate Professor, Department of Medicine and Surgery, Gastroenterology, Hepatology & Digestive Endoscopy Section University of Perugia Medical School, Piazza Lucio Severi, Perugia 06132, Italy, and Santa Maria della Misericordia Hospital, Gastroenterology & Hepatology Unit Perugia 06156, Italy. gabassot@tin.it
Received: September 15, 2022
Peer-review started: September 15, 2022
First decision: November 26, 2022
Revised: December 3, 2022
Accepted: December 27, 2022
Article in press: December 27, 2022
Published online: January 28, 2023
Core Tip

Core Tip: Clostridioides difficile is an opportunistic pathogen that is progressively increasing worldwide. Patients with inflammatory bowel diseases are particularly susceptible due to altered immunological status and the therapies adopted that favor intestinal dysbiosis and colonization by Clostridioides difficile. Recent in vitro studies also suggest that the infection might be favored by the strong cytotoxic synergism between Clostridioides difficile toxin B and proinflammatory cytokines, thetumor necrosis factor-alpha and interferon-gamma. The therapeutic approaches are still limited, and those presently available rely on antibiotic therapy and fecal transplantation.