Host-targeted niclosamide inhibits C. difficile virulence and prevents disease in mice without disrupting the gut microbiota

John Tam, Therwa Hamza, Bing Ma, Kevin Chen, Greg L. Beilhartz, Jacques Ravel, Hanping Feng and Roman A. Melnyk ()
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John Tam: Hospital for Sick Children
Therwa Hamza: University of Maryland Dental School
Bing Ma: University of Maryland School of Medicine
Kevin Chen: University of Maryland Dental School
Greg L. Beilhartz: Hospital for Sick Children
Jacques Ravel: University of Maryland School of Medicine
Hanping Feng: University of Maryland Dental School
Roman A. Melnyk: Hospital for Sick Children

Nature Communications, 2018, vol. 9, issue 1, 1-11

Abstract: Abstract Clostridium difficile is the leading cause of nosocomial diarrhea and colitis in the industrialized world. Disruption of the protective gut microbiota by antibiotics enables colonization by multidrug-resistant C. difficile, which secrete up to three different protein toxins that are responsible for the gastrointestinal sequelae. Oral agents that inhibit the damage induced by toxins, without altering the gut microbiota, are urgently needed to prevent primary disease and break the cycle of antibiotic-induced disease recurrence. Here, we show that the anthelmintic drug, niclosamide, inhibits the pathogenesis of all three toxins by targeting a host process required for entry into colonocytes by each toxin. In mice infected with an epidemic strain of C. difficile, expressing all three toxins, niclosamide reduced both primary disease and recurrence, without disrupting the diversity or composition of the gut microbiota. Given its excellent safety profile, niclosamide may address an important unmet need in preventing C. difficile primary and recurrent diseases.

Date: 2018
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DOI: 10.1038/s41467-018-07705-w

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