Journal of microbiology, epidemiology and immunobiologyJournal of microbiology, epidemiology and immunobiologyЖурнал микробиологии, эпидемиологии и иммунобиологии0372-93112686-7613Central Research Institute for Epidemiology727110.36233/0372-9311-386rpsjliREVIEWSОБЗОРЫReview ArticleType 4 secretion system in Clostridioides difficile: Structural features and its role as a pathogenicity factorСистема секреции 4-го типа у Clostridioides difficile: структурные особенности и её роль как фактора патогенностиhttps://orcid.org/0000-0002-1869-742XSorokinaJulya V.СорокинаЮлия Валерьевна
Russian Federation

Researcher, Department of Bacterial Infections

н.с. отдела бактериальных инфекций

YV_Sorokina@gamaleya.orghttps://orcid.org/0000-0003-2312-1465BelyiYuriy F.БелыйЮрий Фёдорович
Russian Federation

D. Sci. (Med.), Head, Department of Bacterial Infections

д.м.н., рук. отдела бактериальных инфекций

belyi@gamaleya.orgGamaleya Research Centre for Epidemiology and MicrobiologyНациональный исследовательский центр эпидемиологии и микробиологии имени Н.Ф. Гамалеи21092023100434535328032023Copyright ©; 2023, Sorokina J.V., Belyi Y.F.Copyright ©; 2023, Сорокина Ю.В., Белый Ю.Ф.2023Sorokina J.V., Belyi Y.F.Сорокина Ю.В., Белый Ю.Ф.https://creativecommons.org/licenses/by/4.0https://microbiol.crie.ru/jour/article/view/7271

Clostridioides difficile is a gram-positive microorganism causing damage to the human intestinal wall, clinically manifesting as antibiotic-associated diarrhea and pseudomembranous colitis. C. difficile infection remains a serious problem; the increasing frequency of nosocomial outbreaks and the emergence of community-acquired forms heighten the need for new prevention and treatment methods. The pathogenesis of C. difficile infection is associated with the toxins produced by bacteria and a large group of proteins promoting the replication of the pathogen in host tissues and its spread in the human population. Recent studies show that mobile genetic elements play a key role in the high virulence of C. difficile. Type 4 secretion systems (T4SS) are significant components of these elements; their impressive diversity among gram-positive microorganisms in general and in C. difficile, in particular, implies their high evolutionary and, consequently, medical significance. Further studies of the T4SS composition and structure will provide a deeper insight into mechanisms underlying the development of respective infections and will help outline pathogenically grounded approaches to prevention and treatment of diseases caused by C. difficile. On the other hand, the key components of the secretion machinery of the pathogen can be used in bioinformatic analysis and for searching new adaptive clusters in the genome of highly virulent strains.

Clostridioides difficile — грамположительный микроорганизм, вызывающий поражения стенки кишечника человека, которые проявляются клинически в виде антибиотикоассоциированной диареи и псевдомембранозного колита. Проблема инфекции C. difficile не теряет актуальности, а с распространением внутрибольничных вспышек и появлением внебольничных форм растёт потребность в новых видах её профилактики и лечения. Патогенез инфекции C. difficile связан с продукцией бактериями токсинов и большой группы иных белков, благоприятствующих размножению патогена в тканях макроорганизмов и его распространению в популяции людей. Исходя из исследований последних лет можно заключить, что высокой вирулентности C. difficile способствуют мобильные генетические элементы. Важнейшими компонентами этих элементов являются системы секреции 4-го типа (СС4Т), впечатляющее разнообразие которых среди грамположительных микроорганизмов вообще и C. difficile в частности говорит об их высокой эволюционной и, следовательно, медицинской значимости. Дальнейшее изучение состава и строения СС4Т позволит расширить понимание механизмов развития соответствующих инфекций и наметить патогенетически обоснованные подходы к профилактике и лечению заболеваний, вызываемых C. difficile. С другой стороны, ключевые компоненты секреторного аппарата патогена могут быть использованы для биоинформационного анализа и поиска новых адаптивных кластеров в геноме высоковирулентных штаммов.

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