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The adaptive immune response to Clostridioides difficile : A tricky balance between immunoprotection and immunopathogenesis
Author(s) -
Hernández Del Pino Rodrigo Emanuel,
Barbero Angela María,
Español Laureano Ángel,
Morro Lorenzo Sebastián,
Pasquinelli Virginia
Publication year - 2021
Publication title -
journal of leukocyte biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.819
H-Index - 191
eISSN - 1938-3673
pISSN - 0741-5400
DOI - 10.1002/jlb.4vmr0720-201r
Subject(s) - biology , immune system , acquired immune system , immunity , immunology , clostridioides , innate immune system , pathogenesis , disease , mechanism (biology) , inflammation , microbiology and biotechnology , medicine , pathology , philosophy , epistemology
Abstract Clostridioides difficile ( C. difficile ) is the major cause of hospital‐acquired gastrointestinal infections in individuals following antibiotics treatment. The pathogenesis of C. difficile infection (CDI) is mediated mainly by the production of toxins that induce tissue damage and host inflammatory responses. While innate immunity is well characterized in human and animal models of CDI, adaptive immune responses remain poorly understood. In this review, the current understanding of adaptive immunity is summarized and its influence on pathogenesis and disease outcome is discussed. The perspectives on what we believe to be the main pending questions and the focus of future research are also provided. There is no doubt that the innate immune response provides a first line of defense to CDI. But, is the adaptive immune response a friend or a foe? Probably it depends on the course of the disease. Adaptive immunity is essential for pathogen eradication, but may also trigger uncontrolled or pathological inflammation. Most of the understanding of the role of T cells is based on findings from experimental models. While they are a very valuable tool for research studies, more studies in human are needed to translate these findings into human disease. Another main challenge is to unravel the role of the different T cell populations on protection or induction of immunopathogenesis.