Clostridium difficile is the leading cause of hospital-acquired, antibiotic-associated diarrhea, and is the only wide-spread human pathogen that contains a complete set of genes encoding the Wood-Ljungdahl pathway (WLP). In acetogenic bacteria, synthesis of acetate from 2 CO2 by the WLP functions as a terminal electron accepting pathway, however, C. difficile contains various other reductive pathways including a heavy reliance on Stickland reactions, which questions the role of the WLP in this bacterium. In rich medium containing high levels of electron acceptor substrates only trace levels of key WLP enzymes were found, therefore, conditions were developed to adapt C. difficile to grow in the absence of amino acid Stickland acceptors. Growth conditions were identified that produce the highest levels of WLP activity, determined by Western blot analyses of the central component acetyl-CoA synthase (AcsB) and assays of other WLP enzymes. Fermentation substrate and product analyses, enzyme assays of cell extracts, and characterization of an ΔacsB mutant, demonstrated that the WLP functions to dispose of metabolically-generated reducing equivalents. While WLP activity in C. difficile does not reach the levels seen in classical acetogens, coupling of the WLP to butyrate formation provides a highly efficient system for regeneration of NAD+ “acetobutyrogenesis” requiring only low flux through the pathways to support efficient ATP production from glucose oxidation. Additional insights redefine the amino acid requirements in C. difficile, explore the relationship of the WLP to toxin production, and provide a rationale for co-localization of genes involved in glycine synthesis and cleavage within the WLP operon.
IMPORTANCE Clostridium difficile is an anaerobic multidrug-resistant, toxin-producing pathogen with major health impacts worldwide. It is the only wide-spread pathogen harboring a complete set of Wood-Ljungdahl pathway (WLP) genes, however, the role of the WLP in C. difficile is poorly understood. In other anaerobic bacteria and Archaea, the WLP can operate in one direction to convert CO2 to acetic acid for biosynthesis, or in either direction for energy conservation. Herein, conditions are defined in which WLP levels in C. difficile increase markedly, functioning to support metabolism of carbohydrates. Amino acid nutritional requirements were better defined, with new insight into how the WLP and butyrate pathways act in concert, contributing significantly to energy metabolism by a mechanism that may have broad physiological significance within the group of non-classical acetogens.