Clostridioides difficile, the causative agent of
nosocomial antibiotic-associated diarrhea and
pseudomembranous colitis, possesses two main virulence factors: the large clostridial cytotoxins A (TcdA; TC# 1.C.57.1.2) and B (TcdB, TC# 1.C.57.1.1). Action by large clostridial toxins (LCTs) from
Clostridioides difficile includes four steps: (1) receptor-mediated
endocytosis, (2) translocation of a catalytic
glucosyltransferase domain across the membrane, (3) release of the enzymatic part by auto-proteolysis, and (4) inactivation of Rho family proteins. Cleavage of toxin B and all other large clostridial cytotoxins, is an autocatalytic process dependent on host cytosolic inositolphosphate cofactors. A covalent inhibitor of aspartate proteases, 1,2-epoxy-3-(p-nitrophenoxy)propane or EPNP, completely blocks toxin B function on cultured cells and has been used to identify the catalytically active protease site. The toxin uses eukaryotic signals for induced autoproteolysis to deliver its toxic domain into the
cytosol of target cells. Reineke et al. (2007) present an integrated model for the uptake and
inositol phosphate-induced activation of toxin B.
Clostridioides difficile infection, caused by the actions of the homologous toxins TcdA and TcdB on colonic epithelial cells is due to binding to target cells which triggers toxin internalization into acidified vesicles, whereupon cryptic segments from within the 1,050-aa translocation domain unfurl and insert into the bounding membrane, creating a transmembrane passageway to the cytosol. Sensitive residues-clustered between amino acyl residues 1,035 and 1,107, when individually mutated, reduced cellular toxicity by >1,000-fold. Defective variants exhibit impaired pore formation in planar lipid bilayers and biological membranes, resulting in an inability to intoxicate cells through either apoptotic or necrotic pathways. The findings suggest similarities between the pore-forming 'hotspots' of TcdB and the
diphtheria toxin translocation domain. == Function ==