1 2 3 4 The C. difficile clnRAB operon initiates adaptations to the host environment in 5 response to LL-37 6 7 24 25 2 26 ABSTRACT27 To cause disease, Clostridioides (Clostridium) difficile must resist killing by innate immune effectors in 28 the intestine, including the host antimicrobial peptide, cathelicidin . The mechanisms that 29 enable C. difficile to adapt to the intestine in the presence of antimicrobial peptides are unknown.30 Expression analyses revealed an operon, CD630_16170-CD630_16190 (clnRAB), which is highly 31 induced by LL-37 and is not expressed in response to other cell-surface active antimicrobials. This 32 operon encodes a predicted transcriptional regulator (clnR) and an ABC transporter system (clnAB), 33 all of which are required for function. Analyses of a clnR mutant indicate that ClnR is a pleiotropic 34 regulator that directly binds to LL-37 and controls expression of numerous genes, including many 35 involved in metabolism, cellular transport, signaling, gene regulation, and pathogenesis. The data 36 suggest that ClnRAB is a novel regulatory mechanism that senses LL-37 as a host signal and 37 regulates gene expression to adapt to the host intestinal environment during infection.
3839 Author Summary 40 C. difficile is a major nosocomial pathogen that causes severe diarrheal disease. Though C. difficile is 41 known to inhabit the human gastrointestinal tract, the mechanisms that allow this pathogen to adapt 42 to the intestine and survive host defenses are not known. In this work, we investigated the response 43 of C. difficile to the host defense peptide, LL-37, to determine the mechanisms underlying host 44 adaptation and survival. Expression analyses revealed a previously unknown locus, which we named 45 clnRAB, that is highly induced by LL-37 and acts as a global regulator of gene expression in C.46 difficile. Mutant analyses indicate that ClnRAB is a novel regulatory system that senses LL-37 as a 47 host signal to regulate adaptation to the intestinal environment.
49Clostridioides difficile (formerly Clostridium difficile) poses a serious, ongoing, public health 50 threat. C. difficile infection (CDI) results in mild to severe diarrhea and leads to approximately 29,000 51 deaths each year in the United States (1). Patients are typically infected after treatment with 52 antibiotics, which disrupt the intestinal microbiota that provide colonization resistance against CDI by 53 competition and release of antimicrobial peptides (AMPs) (1, 2).
54The host innate immune system also plays an important role in the prevention of infections. A 55 critical feature of this defense is the production of AMPs, including defensins, cathelicidin (LL-37), and 56 lysozyme (3, 4). LL-37, a cationic AMP, is of particular importance in CDI because it is not only 57 produced constitutively in the colon by the colonic epithelium, but is also released in high levels from58 neutrophils, which are a key component of the initial immune response to CDI (5). LL-37 is stored in 59 neutrophil granules at a conce...