ve Cefoperazone-tedavi edilmiş fare modeli klinik olarak ilgili<em> Clostridium difficile</em> Gerilme R20291
Summary
Bu protokol klinik olarak ilgili ve genetik uysal gerginlik, R20291 kullanarak Clostridium difficile enfeksiyonu (CDI) sefoperazon fare modeli özetliyor. Klinik hastalık izleme, C. difficile bakteriyel numaralandırma, toksin sitotoksisite ve bir fare modelinde CDI genelinde histopatolojik değişikliklere vurgu protokolde ayrıntılı olarak verilmiştir.
Abstract
Clostridium difficile is an anaerobic, gram-positive, spore-forming enteric pathogen that is associated with increasing morbidity and mortality and consequently poses an urgent threat to public health. Recurrence of a C. difficile infection (CDI) after successful treatment with antibiotics is high, occurring in 20-30% of patients, thus necessitating the discovery of novel therapeutics against this pathogen. Current animal models of CDI result in high mortality rates and thus do not approximate the chronic, insidious disease manifestations seen in humans with CDI. To evaluate therapeutics against C. difficile, a mouse model approximating human disease utilizing a clinically-relevant strain is needed. This protocol outlines the cefoperazone mouse model of CDI using a clinically-relevant and genetically-tractable strain, R20291. Techniques for clinical disease monitoring, C. difficile bacterial enumeration, toxin cytotoxicity, and histopathological changes throughout CDI in a mouse model are detailed in the protocol. Compared to other mouse models of CDI, this model is not uniformly lethal at the dose administered, allowing for the observation of a prolonged clinical course of infection concordant with the human disease. Therefore, this cefoperazone mouse model of CDI proves a valuable experimental platform to assess the effects of novel therapeutics on the amelioration of clinical disease and on the restoration of colonization resistance against C. difficile.
Introduction
Clostridium difficile hayatı tehdit eden ishal 1 neden olan bir anaerobik, gram pozitif, spor oluşturan basildir. C. difficile enfeksiyonu (CDI) yıl 1-4 başına sağlık maliyetlerinde üzerinde 4800000000 $ artmış, insan morbidite ve mortalite ve sonuçları ile ilişkilidir. 2013 yılında, Hastalık Kontrol ve Önleme Merkezleri kamu sağlığı 1 acil tehlike teşkil ettiğini gösteren, acil antibiyotik direnç riski C. difficile kategorize. Şu anda, antibiyotik vankomisin ile tedavi ve metronidazol CDI 5 için standart bakım olarak kabul edilir. Hastaların 2,5-7% 30 – Ne yazık ki, antibiyotik başarılı tedavi sonrası CDI tekrar 20 meydana gelen, yüksek. Bu nedenle, bu enterik patojene karşı yeni terapötiklerin keşfi gereklidir. C. difficile, ac insan hastalığı yaklaşan bir hayvan modelinde karşı ilaç gruplarına değerlendirmeklinically-İlgili suşu gereklidir.
Başlangıçta, Koch Postülatları bir klindamisin ile tedavi edilen Suriye hamster modeli 8 kullanılarak 1977 yılında C. difficile için kurulmuştur. Bu model hala patogenezi 9,10 C. difficile toksin etkilerini araştırmak için bugün kullanılmaktadır. Ancak, CDI Hamster modelinde yüksek mortalite oranları ile sonuçlanır ve CDI 10,11 insanlarda görülebilir kronik sinsi hastalık belirtilerinin yaklaştığı değildir. Araştırmada sıçangil platformlar erişilebilirlik ve reaktif durumuna göre, CDI bir fare modeli uygundur.
2008 yılında, CDI sağlam bir fare modeli klindamisin 12 bir intraperitoneal enjeksiyon, ardından 3 gün bir antibiyotik içme suyu kokteyl (kanamisin, gentamisin, kolistin, metronidazol ve vankomisin) fareler muamele edilmesiyle kurulmuştur. CDI ve şiddetli kolit duyarlı Bu hale fareler. bağlıuygulanan aşı doz ing, klinik belirti ve letalitesinin bir dizi bu model kullanılarak görülebilir. Bu zamandan beri, çeşitli antibiyotik rejimleri C. difficile gastrointestinal sistem kolonize olabilir noktaya kolonizasyon direnci azalan, fare bağırsak Mikrobiyota değiştiren incelenmiştir (En ark gözden geçirdik. Ve Lawley & Young) 13,14.
Daha yakın zamanlarda, 5 ya da 10 gün boyunca içme suyu verilen geniş spektrumlu sefalosporinler, sefoperazon, tekrarlanabilir CDI 15 duyarlı fare oluşturur. Üçüncü kuşak sefalosporin verilmesinin insanlarda CDI riski ile ilişkili olduğundan, sefoperazon modelinin kullanımı daha doğru bir hastalık 16 doğal olarak meydana gelen yansıtır. Sefoperazon ile tedavi edilen C. difficile duyarlı fareler C. difficile sporlarının ve klinik olarak değişen suşları çeşitli bitkisel hücreler hem meydan edilmiştiralaka ve virülans 17. Bulaşıcı form olarak C. difficile vejetatif hücreleri kullanılarak özgün çalışmaların bazılarında rağmen, C. difficile sporlarının iletim 18 ana mod olarak kabul edilir.
Son on yılda, C. difficile R20291, bir NAP1 / BI / 027 suşu, CDI 19,20 salgınlara neden ortaya çıkmıştır. Biz sefoperazon ile tedavi edilmiş fareler klinik olarak ilgili ve genetik uysal C. difficile suşu, R20291 aşılandığında hastalığın klinik seyrini belirlemeye çalıştık. Bu protokol kilo kaybı, bakteri kolonizasyonu, toksin sitotoksisite ve C. difficile R20291 sporları ile meydan farelerin gastrointestinal sistemde histopatolojik değişiklikler de dahil olmak üzere, klinik seyir ayrıntıları. Genel olarak, bu fare modeli CDI insan hastalığı yaklaştırmak için değerli bir deney platformu olduğunu kanıtlamaktadır. Bu özelliği, fare modeli, etkilerini değerlendirmek için kullanılabilirklinik hastalığın iyileştirilmesi ve C. difficile karşı kolonizasyon direnci restorasyonu yeni tedavi yöntemleri.
Protocol
Representative Results
Discussion
This protocol characterizes the clinical course, including weight loss, bacterial colonization, toxin cytotoxicity, and histopathological changes in the gastrointestinal tract, of antibiotic-treated mice challenged with C. difficile R20291 spores. There are several critical steps within the protocol where attention to detail is essential. Accurate calculation of the C. difficile spore inoculum is critical. This calculation is based on the original C. difficile spore stock enumeration, which sho…
Disclosures
The authors have nothing to disclose.
Acknowledgements
The authors would like to thank Trevor Lawley at the Wellcome Trust Sanger Institute for C. difficile R20291 spores and James S. Guy at the North Carolina State University College of Veterinary Medicine for Vero cells, both utilized in this manuscript. Animal histopathology was performed in the LCCC Animal Histopathology Core Facility at the University of North Carolina at Chapel Hill, with special assistance from Traci Raley and Amanda Brown. The LCCC Animal Histopathology Core is supported in part by an NCI Center Core Support Grant (2P30CA016086-40) to the UNC Lineberger Comprehensive Cancer Center. We would also like to thank Vincent Young, Anna Seekatz, Jhansi Leslie, and Cassie Schumacher for helpful discussions on the Vero cell cytotoxicity assay protocol. JAW is funded by the Ruth L. Kirschstein National Research Service Award Research Training grant T32OD011130 by NIH. CMT is funded by the career development award in metabolomics grant K01GM109236 by the NIGMS of the NIH.
Materials
| #62 Perisept Sporidicial Disinfectant Cleaner | SSS Navigator | 48027 | This product will require dilution as recommended by the manufacturer |
| 0.22 μm filter | Fisherbrand | 09-720-3 | Alternative to filter plate for indivdiual samples tested in the Vero Cell Assay |
| 0.25% Trypsin-EDTA | Gibco | 25200-056 | Needs to be heated in water bath at 37C prior to use |
| 0.4% Trypan Blue | Gibco | 15250-061 | |
| 1% Peniciilin/Streptomycin | Gibco | 15070-063 | |
| 10% heat inactivated FBS | Gibco | 16140-071 | Needs to be heated in water bath at 37C prior to use |
| 1ml plastic syringe | BD Medical Supplies | 309628 | |
| 1X PBS | Gibco | 10010-023 | |
| 2 ml Micro Centrifuge Screw Cap | Corning | 430917 | |
| 96 well cell culture flat bottom plate | Costar Corning | CL3595 | |
| 96 well filter plate | Millipore | MSGVS2210 | |
| Adhesive Seal | ThermoScientific | AB-0558 | |
| Bacto Agar | Becton Dickinson | 214010 | Part of TCCFA plates (see below) |
| Bacto Proteose Peptone | Becton Dickinson | 211684 | Part of TCCFA plates (see below) |
| Cefoperazone | MP Bioworks | 199695 | |
| Cefoxitine | Sigma | C47856 | Part of TCCFA plates (see below) |
| Clostridium difficile Antitoxin Kit | Tech Labs | T5000 | Used as control for Vero Cell Assay |
| Clostridium difficile Toxin A | List Biological Labs | 152C | Positive control for Vero Cell Assay |
| D-cycloserine | Sigma | C6880 | Part of TCCFA plates (see below) |
| Distilled Water | Gibco | 15230 | |
| DMEM 1X Media | Gibco | 11965-092 | Needs to be heated in water bath at 37C prior to use |
| Fructose | Fisher | L95500 | Part of TCCFA plates (see below) |
| Hemocytometer | Bright-Line, Sigma | Z359629 | |
| KH2PO4 | Fisher | P285-500 | Part of TCCFA plates (see below) |
| MgSO4 (anhydrous) | Sigma | M2643 | Part of TCCFA plates (see below) |
| Millex-GS 0.22 μm filter | Millex-GS | SLGS033SS | Filter for TCCFA plates |
| Na2HPO4 | Sigma | S-0876 | Part of TCCFA plates (see below) |
| NaCl | Fisher | S640-3 | Part of TCCFA plates (see below) |
| Number 10 disposable scalpel blade | Miltex, Inc | 4-410 | |
| PCR Plates | Fisherbrand | 14230244 | |
| Plastic petri dish | Kord-Valmark Brand | 2900 | |
| Sterile plastic L-shaped cell spreader | Fisherbrand | 14-665-230 | |
| Syringe Stepper | Dymax Corporation | T15469 | |
| Taurocholate | Sigma | T4009 | Part of TCCFA plates (see below) |
| Ultrapure distilled water | Invitrogen | 10977-015 | |
| C57BL/6J Mice | The Jackson Laboratory | 664 | Mice should be 5-8 weeks of age |
| Olympus BX43F light microscope | Olympus Life Science | ||
| DP27 camera | Olympus Life Science | ||
| cellSens Dimension software | Olympus Life Science |
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