C. Diff Treatment: Don't Pour Some Sugar on Me

By Lila Abassi — May 12, 2016
A potential breakthrough in developing a vaccine against Clostridum difficile infections has been achieved by scientists at the Max Planck Institute of Colloids and Interfaces. “C. diff” is the causative agent of a nasty diarrheal illness that has plagued healthcare facilities the world over.
Clostridium difficile courtesy of shutterstock Clostridium difficile courtesy of shutterstock

Clostridium difficile, better known as “C. diff” is the causative agent of a nasty diarrheal illness that has plagued healthcare facilities the world over. It is generally associated with widespread antibiotic use, which subsequently leads to a disruption of intestinal flora, wiping out the good bacteria and allowing the bad bacteria to flourish unabated. It is commonly regarded as a hospital-acquired infection chiefly among those patients over 65 years of age.

Scientists at Max Planck Institute of Colloids and Interfaces may have developed a potential vaccine to combat C. diff. The basic structure of a bacterial cell is comprised mostly of peptidoglycan or murein. Peptidoglycan is basically a cross-linking network of many disaccharides (glycan) with short chains of identical amino acids (peptides). The peptidoglycan has a type of glucose-derived backbone called NAG (N-acetylglucosamine) and NAM (N-acetylmuramic acid).

The study, which was published in Nature Communications, reveals that the scientists have been able to construct a molecule that resembles this glucose coat on bacterial surfaces, which is able to elicit an immune response similar to an actual C. diff infection.  The antibodies generated from this molecule primes the immune system to fend off any potential future C. diff infections.

The challenge in developing this potential vaccine was creating a structure that resembled the sugar-based cell surface of the bacteria enough so that a strong antibody response would ensue. By synthesizing many small molecules of sugar, instead of one large molecules increased the order of magnitude of antibody response five-fold. And from an organic chemistry point of view, these smaller, simpler molecules are much cheaper and easier to synthesize.

“Our findings are a very good example of how basic research into the human immune response to sugars can lead to new candidates in the fight against dangerous hospital germs,” stated Peter H. Seeberger, Director at the Max Planck Insitute of Colloids and Interfaces and professor at Freie Universitat Berlin.

The reason why this could be a potential game changer as far as treatments are concerned is that it would eliminate the need for antibiotics – which is the most common reason why people develop the infection in the first place. And with C. diff becoming increasingly difficult to treat, developing a new weapon against this deadly infection would prevent much suffering, save many lives and save 4.8 billion dollars annually in excess healthcare costs. It is estimated that almost half a million infections occur in the U.S. annually with 29,000 deaths within the first 30 days of infection, and 15,000 deaths directly caused by C. diff infections.