Clostridium difficile enterotoxin

Krivan HC, Clark GF, Smith DF, Wilkins TD Cell surface binding site for Clostridium difficile enterotoxin Evidence for a glycoconjugate containing the sequence Gal alpha l-3Galbeta l-4GlcNAc. Infect Immun 1986 53 573-581. 

Kushnaryov VM, Sedmak JJ (1989) Effect of Clostridium difficile enterotoxin A on ultrastructure of Chinese hamster ovary cells. In Infect. Immun. 57 3914-3921. 

Just I, Wilm M, Selzer J, Rex G, von Eichel-Streiber C, Mann M, Aktories K The enterotoxin from Clostridium difficile (ToxA) mono-glucosylates the Rho proteins. J Biol Chem 1995 270 13932-13936. 

Clostridium difficile is a commensal Gram-positive anaerobic bacterium of the human intestine, found in about 2-5% of the population. C. difficile is the most serious cause of antibiotic-associated diarrhoea and can lead to pseudomembranous colitis, a severe infection of the colon, often resulting from eradication of the normal gut flora by antibiotics. Discontinuation of causative antibiotic treatment is often curative. In more serious cases, oral administration of metronidazole or vancomycin is the treatment of choice. The bacterium produces several known toxins, including enterotoxin (toxin A) and cytotoxin (toxin B), both of which are responsible for the diarrhoea and inflammation seen in infected patients another toxin, binary toxin, has also been described. 

Castagliuolo I, LaMont JT, Letourneau R, etal. (1994) Neuronal involvement in the intestinal effects of Clostridium difficile toxin A and Vibrio cholerae enterotoxin in rat ileum. In Gastroenterol. 107 657—665. 

Due to adsorptive property, clays can adsorb a variety of toxic substances, such as strychnine, mycotoxins, aflatoxin and toxins. Clay can provide active protection against disturbances dming gastrointestinal transit. However, if the toxin is incubated with smectite for 24 h beforehand, no increase in the rate of gastric emptying and small intestinal transit occurs. Smectite can also adsorb the enterotoxin of Clostridium difficile. In rats, this toxin causes intestinal permeability to increase through hyperseeretion of colonic water. 

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