P2X7 receptor blockade decreases inflammation, apoptosis, and enteric neuron loss during Clostridioides difficile toxin A-induced ileitis in mice

Author(s)

Santos, Ana A. Q. A. ; Costa, Deiziane V. S. ; Foschetti, Danielle A. ; Duarte, Antoniella S. G. ; Martins, Conceicao S. ; Soares, Pedro M. G. ; Castelucci, Patricia ; Brito, Gerly A. C.

• Document type: Journal article
• Source: WORLD JOURNAL OF GASTROENTEROLOGY; v. 28, n. 30, p. 14-pg., 2022-08-14.

Abstract

BACKGROUND Clostridioides difficile (C. difficile) is the most common pathogen causing health care-associated infections. C. difficile TcdA and TcdB have been shown to activate enteric neurons; however, what population of these cells is more profoundly influenced and the mechanism underlying these effects remain unknown. AIM To characterize a specific population of TcdA-affected myenteric neurons and investigate the role of the P2X7 receptor in TcdA-induced ileal inflammation, cell death, and the changes in the enteric nervous system in mice. METHODS Swiss mice were used to model TcdA-induced ileitis in ileal loops exposed to TcdA (50 mu g/Loop) for 4 h. To investigate the role of the P2X7 receptor, Brilliant Blue G (50 mg/kg, i.p.), which is a nonspecific P2X7 receptor antagonist, or A438079 (0.7 mu g/mouse, i.p.), which is a competitive P2X7 receptor antagonist, were injected one hour prior to TcdA challenge. Ileal samples were collected to analyze the expression of the P2X7 receptor (by quantitative real-time polymerase chain reaction and immunohistochemistry), the population of myenteric enteric neurons (immunofluorescence), histological damage, intestinal inflammation, cell death (terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling), neuronal loss, and S100B synthesis (immunohistochemistry). RESULTS TcdA upregulated (P < 0.05) the expression of the P2X7 receptor gene in the ileal tissues, increasing the level of this receptor in myenteric neurons compared to that in control mice. Comparison with the control mice indicated that TcdA promoted (P < 0.05) the loss of myenteric calretinin+ (Calr) and choline acetyltransferase+ neurons and increased the number of nitrergic+ and Calr+ neurons expressing the P2X7 receptor. Blockade of the P2X7 receptor decreased TcdA-induced intestinal damage, cytokine release [interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor-alpha], cell death, enteric neuron loss, and S100B synthesis in the mouse ileum. CONCLUSION Our findings demonstrated that TcdA induced the upregulation of the P2X7 receptor, which promoted enteric neuron loss, S100B synthesis, tissue damage, inflammation, and cell death in the mouse ileum. These findings contribute to the future directions in understanding the mechanism involved in intestinal dysfunction reported in patients after C. difficile infection. (AU)

• FAPESP's process: 14/25927-2 - Morphological, molecular and functional aspects of the interaction between the P2X7 receptor and pannexin-1 in the enteric glial cells following intestinal ischemia/reperfusion
• Grantee: Patricia Castelucci
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/07862-1 - Study of the effect of experimental ulcerative colitis on the enteric nervous system of P2X7 receptor deficient mice (P2X7-/-)
• Grantee: Patricia Castelucci
• Support Opportunities: Regular Research Grants