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Loureiro AV, Barbosa MLL, Morais MLGS, Souza IP, Terceiro LS, Martins CS, Sousa APR, Leitão RFC, Shin JH, Warren CA, Costa DVS, Brito GAC. Host and Clostridioides difficile-Response Modulated by Micronutrients and Glutamine: An Overview. Front Nutr 2022; 9:849301. [PMID: 35795588 PMCID: PMC9251358 DOI: 10.3389/fnut.2022.849301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Changes in intestinal microbiota are integral to development of Clostridioides difficile (C. difficile)—associated nosocomial diarrhea. Certain diets, especially Western diets, increase susceptibility to C. difficile infection (CDI). Here, we discuss recent findings regarding how nutrients modulate response of the host and C. difficile during infection. Calcium has a role in the sporulation and germination process. Selenium is effective in reducing the total amount of C. difficile toxin A (TcdA) and toxin B (TcdB) and in decreasing its cytotoxicity. In addition, selenium phosphate synthetase deficiency reduces C. difficile growth and spore production. On the other hand, iron has a dual role in C. difficile growth. For instance, high intracellular levels can generate reactive hydroxyl radicals, whereas low levels can reduce its growth. In humans, zinc deficiency appears to be related to the recurrence of CDI, in contrast, in the CDI model in mice a diet rich in zinc increased the toxin's activity. Low vitamin D levels contribute to C. difficile colonization, toxin production, and inflammation. Furthermore, glutamine appears to protect intestinal epithelial cells from the deleterious effects of TcdA and TcdB. In conclusion, nutrients play an important role in modulating host and pathogen response. However, further studies are needed to better understand the mechanisms and address some controversies.
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Affiliation(s)
- Andréa V. Loureiro
- Department of Medical Sciences, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Maria L. L. Barbosa
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Maria L. G. S. Morais
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Ismael P. Souza
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Letícia S. Terceiro
- Department of Medical Sciences, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Conceição S. Martins
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Arkila P. R. Sousa
- Department of Pharmacology and Physiology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Renata F. C. Leitão
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Jae H. Shin
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, VA, United States
| | - Cirle A. Warren
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, VA, United States
| | - Deiziane V. S. Costa
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, VA, United States
| | - Gerly A. C. Brito
- Department of Medical Sciences, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Department of Pharmacology and Physiology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- *Correspondence: Gerly A. C. Brito
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Zuhl M, Dokladny K, Mermier C, Schneider S, Salgado R, Moseley P. The effects of acute oral glutamine supplementation on exercise-induced gastrointestinal permeability and heat shock protein expression in peripheral blood mononuclear cells. Cell Stress Chaperones 2015; 20:85-93. [PMID: 25062931 PMCID: PMC4255255 DOI: 10.1007/s12192-014-0528-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 06/25/2014] [Accepted: 07/14/2014] [Indexed: 02/04/2023] Open
Abstract
Chronic glutamine supplementation reduces exercise-induced intestinal permeability and inhibits the NF-κB pro-inflammatory pathway in human peripheral blood mononuclear cells. These effects were correlated with activation of HSP70. The purpose of this paper is to test if an acute dose of oral glutamine prior to exercise reduces intestinal permeability along with activation of the heat shock response leading to inhibition of pro-inflammatory markers. Physically active subjects (N = 7) completed baseline and exercise intestinal permeability tests, determined by the percent ratio of urinary lactulose (5 g) to rhamnose (2 g). Exercise included two 60-min treadmill runs at 70 % of VO2max at 30 °C after ingestion of glutamine (Gln) or placebo (Pla). Plasma levels of endotoxin and TNF-α, along with peripheral blood mononuclear cell (PBMC) protein expression of HSP70 and IκBα, were measured pre- and post-exercise and 2 and 4 h post-exercise. Permeability increased in the Pla trial compared to that at rest (0.06 ± 0.01 vs. 0.02 ± 0.018) and did not increase in the Gln trial. Plasma endotoxin was lower at the 4-h time point in the Gln vs. 4 h in the Pla (6.715 ± 0.046 pg/ml vs. 7.952 ± 1.11 pg/ml). TNF-α was lower 4 h post-exercise in the Gln vs. Pla (1.64 ± 0.09 pg/ml vs. 1.87 ± 0.12 pg/ml). PBMC expression of IkBα was higher 4 h post-exercise in the Gln vs. 4 h in the Pla (1.29 ± 0.43 vs. 0.8892 ± 0.040). HSP70 was higher pre-exercise and 2 h post-exercise in the Gln vs. Pla (1.35 ± 0.21 vs. 1.000 ± 0.000 and 1.65 ± 0.21 vs. 1.27 ± 0.40). Acute oral glutamine supplementation prevents an exercise-induced rise in intestinal permeability and suppresses NF-κB activation in peripheral blood mononuclear cells.
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Affiliation(s)
- Micah Zuhl
- Department of Health, Exercise, and Sport Science, University of New Mexico, Albuquerque, NM, 87131, USA,
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Rodrigues RS, Oliveira RAC, Li Y, Zaja-Milatovic S, Costa LB, Braga Neto MB, Kolling GL, Lima AA, Guerrant RL, Warren CA. Intestinal epithelial restitution after TcdB challenge and recovery from Clostridium difficile infection in mice with alanyl-glutamine treatment. J Infect Dis 2013; 207:1505-15. [PMID: 23359592 DOI: 10.1093/infdis/jit041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Clostridium difficile is an anaerobic bacterium that causes antibiotic-associated diarrhea. It produces toxin A and toxin B (TcdB), which cause injury to the gut epithelium. Glutamine is a fundamental fuel for enterocytes, maintaining intestinal mucosal health. Alanyl-glutamine (AQ) is a highly soluble dipeptide derivative of glutamine. We studied whether administration of AQ ameliorates the effects of TcdB in the intestinal cells and improves the outcome of C. difficile infection in mice. METHODS WST-1 proliferation and cell-wounding-migration assays were assessed in IEC-6 cells exposed to TcdB, with or without AQ. Apoptosis and necrosis were assessed using Annexin V and flow cytometry. C57BL/6 mice were infected with VPI 10463 and treated with either vancomycin, AQ, or vancomycin with AQ. Intestinal tissues were collected for histopathologic analysis, apoptosis staining, and determination of myeloperoxidase activity. RESULTS AQ increased proliferation in intestinal cells exposed to TcdB, improved migration at 24 and 48 hours, and reduced apoptosis in intestinal cells challenged with TcdB. Infected mice treated with vancomycin and AQ had better survival and histopathologic findings than mice treated with vancomycin alone. CONCLUSIONS AQ may reduce intestinal mucosal injury in C. difficile-infected mice by partially reversing the effects of TcdB on enterocyte proliferation, migration, and apoptosis, thereby improving survival from C. difficile infection.
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Mühling J, Burchert D, Langefeld TW, Matejec R, Harbach H, Engel J, Wolff M, Welters ID, Fuchs M, Menges T, Krüll M, Hempelmann G. Pathways involved in alanyl-glutamine-induced changes in neutrophil amino- and α-keto acid homeostasis or immunocompetence. Amino Acids 2006; 33:511-24. [PMID: 17072790 DOI: 10.1007/s00726-006-0395-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Accepted: 07/18/2006] [Indexed: 10/24/2022]
Abstract
We examined the effects of DON [glutamine-analogue and inhibitor of glutamine-requiring enzymes], alanyl-glutamine (regarding its role in neutrophil immunonutrition) and alanyl-glutamine combined with L-NAME, SNAP, DON, beta-alanine and DFMO on neutrophil amino and alpha-keto acid concentrations or important neutrophil immune functions in order to establish whether an inhibitor of *NO-synthase [L-NAME], an *NO donor [SNAP], an analogue of taurine and a taurine transport antagonist [beta-alanine], an inhibitor of ornithine-decarboxylase [DFMO] as well as DON could influence any of the alanyl-glutamine-induced effects. In summary, irrespective of which pharmacological, metabolism-inhibiting or receptor-mediated mechanisms were involved, our results showed that impairment of granulocytic glutamine uptake, modulation of intracellular glutamine metabolisation and/or de novo synthesis as well as a blockade of important glutamine-dependent metabolic processes may led to significant modifications of physiological and immunological functions of the affected cells.
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Affiliation(s)
- J Mühling
- Clinic of Anaesthesiology, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Federal Republic of Germany.
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