New treatment approaches for Clostridioides difficile infections : alternatives to antibiotics and fecal microbiota transplantation

Bratkovič, Tomaž (avtor), Zahirović, Abida (avtor), Bizjak, Maruša (avtor), Rupnik, Maja (avtor), Štrukelj, Borut (avtor), Berlec, Aleš (avtor)

Clostridioides difficile causes a range of debilitating intestinal symptoms that may be fatal. It is particularly problematic as a hospital-acquired infection, causing significant costs to the health care system. Antibiotics, such as vancomycin and fidaxomicin, are still the drugs of choice for C. difficile infections, but their effectiveness is limited, and microbial interventions are emerging as a new treatment option. This paper focuses on alternative treatment approaches, which are currently in various stages of development and can be divided into four therapeutic strategies. Direct killing of C. difficile (i) includes beside established antibiotics, less studied bacteriophages, and their derivatives, such as endolysins and tailocins. Restoration of microbiota composition and function (ii) is achieved with fecal microbiota transplantation, which has recently been approved, with standardized defined microbial mixtures, and with probiotics, which have been administered with moderate success. Prevention of deleterious effects of antibiotics on microbiota is achieved with agents for the neutralization of antibiotics that act in the gut and are nearing regulatory approval. Neutralization of C. difficile toxins (iii) which are crucial virulence factors is achieved with antibodies/antibody fragments or alternative binding proteins. Of these, the monoclonal antibody bezlotoxumab is already in clinical use. Immunomodulation (iv) can help eliminate or prevent C. difficile infection by interfering with cytokine signaling. Small-molecule agents without bacteriolytic activity are usually selected by drug repurposing and can act via a variety of mechanisms. The multiple treatment options described in this article provide optimism for the future treatment of C. difficile infection.

• Jezik: Angleški jezik
• Ključne besede: microbiota, immunomodulators, Clostridioides difficile, treatment strategy, bacteriophages, antibodies, immunomodulation
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.02 - Pregledni znanstveni članek
• Organizacija: FFA - Fakulteta za farmacijo
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2024
• Št. strani: 34 str.
• Številčenje: Vol. 16, no. 1, art. 2337312
• PID: 20.500.12556/RUL-164632
• UDK: 615
• ISSN pri članku: 1949-0984
• DOI: 10.1080/19490976.2024.2337312
• COBISS.SI-ID: 192145923
• Datum objave v RUL: 06.11.2024

Gradivo je del revije

• Naslov: Gut microbes
• Založnik: Taylor & Francis
• ISSN: 1949-0984
• COBISS.SI-ID: 522490137

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: mikrobiota, imunomodulacija, Clostridium difficile, terapevtika, bakteriofagi, protitelesa