2′FL and LNnT Exert Antipathogenic Effects against <i>C. difficile</i> ATCC 9689 In Vitro, Coinciding with Increased Levels of <i>Bifidobacteriaceae</i> and/or Secondary Bile Acids

oleh: Louise Kristine Vigsnaes, Jonas Ghyselinck, Pieter Van den Abbeele, Bruce McConnell, Frédéric Moens, Massimo Marzorati, Danica Bajic

Format: Article
Diterbitkan: MDPI AG 2021-07-01

Deskripsi

<i>Clostridioides difficile</i> (formerly <i>Clostridium difficile</i>) infection (CDI) is one of the most common hospital-acquired infections, which is often triggered by a dysbiosed indigenous gut microbiota (e.g., upon antibiotic therapy). Symptoms can be as severe as life-threatening colitis. The current study assessed the antipathogenic potential of human milk oligosaccharides (HMOs), i.e., 2′-O-fucosyllactose (2′FL), lacto-N-neotetraose (LNnT), and a combination thereof (MIX), against <i>C. difficile</i> ATCC 9689 using in vitro gut models that allowed the evaluation of both direct and, upon microbiota modulation, indirect effects. During a first 48 h fecal batch study, dysbiosis and CDI were induced by dilution of the fecal inoculum. For each of the three donors tested, <i>C. difficile</i> levels strongly decreased (with >4 log CFU/mL) upon treatment with 2′FL, LNnT and MIX versus untreated blanks, coinciding with increased acetate/<i>Bifidobacteriaceae</i> levels. Interindividual differences among donors at an intermediate time point suggested that the antimicrobial effect was microbiota-mediated rather than being a direct effect of the HMOs. During a subsequent 11 week study with the Pathogut<sup>TM</sup> model (specific application of the Simulator of the Human Intestinal Microbial Ecosystem (SHIME<sup>®</sup>)), dysbiosis and CDI were induced by clindamycin (CLI) treatment. Vancomycin (VNC) treatment cured CDI, but the further dysbiosis of the indigenous microbiota likely contributed to CDI recurrence. Upon co-supplementation with VNC, both 2′FL and MIX boosted microbial activity (acetate and to lesser extent propionate/butyrate). Moreover, 2′FL avoided CDI recurrence, potentially because of increased secondary bile acid production. Overall, while not elucidating the exact antipathogenic mechanisms-of-action, the current study highlights the potential of HMOs to combat CDI recurrence, help the gut microbial community recover after antibiotic treatment, and hence counteract the adverse effects of antibiotic therapies.