The capability of a recombinant mucin-like fusion protein, P-selectin glycoprotein ligand-1/mouse IgG2b (PSGL-1/mIgG2b), carrying Gal␣1,3Gal1,4GlcNAc determinants to bind and inhibit Clostridium difficile toxin A (TcdA) was investigated. The fusion protein, produced by a glyco-engineered stable CHO-K1 cell line and designated C-PGC2, was purified by affinity and gel filtration chromatography from large-scale cultures. Liquid chromatography-mass spectrometry was used to characterize Oglycans released by reductive -elimination, and new diagnostic ions to distinguish Gal␣1,3Gal-from Gal␣1,4Gal-terminated O-glycans were identified. The C-PGC2 cell line, which was 20-fold more sensitive to TcdA than the wild-type CHO-K1, is proposed as a novel cell-based model for TcdA cytotoxicity and neutralization assays. The C-PGC2-produced fusion protein could competitively inhibit TcdA binding to rabbit erythrocytes, making it a high-efficiency inhibitor of the hemagglutination property of TcdA. The fusion protein also exhibited a moderate capability for neutralization of TcdA cytotoxicity in both C-PGC2 and CHO-K1 cells, the former with and the latter without cell surface Gal␣1,3Gal1,4GlcNAc sequences. Future studies in animal models of C. difficile infection will reveal its TcdA-inhibitory effect and therapeutic potential in C. difficile-associated diseases.C lostridium difficile is an opportunistic Gram-positive pathogenic bacterium responsible for antibiotic-associated diarrhea and other gastrointestinal diseases. C. difficile infections, collectively known as C. difficile-associated disease (CDAD), range from mild cases of diarrhea to fatal pseudomembranous colitis (1, 2). Various treatment options for CDAD include antibiotics, fecal transplantation therapy, and, potentially, toxin-specific antibodies, vaccines, and replenishment of the patient microflora with oral probiotic therapy (3, 4). However, the emergence of strains with reduced susceptibility to antibiotics such as metronidazole and vancomycin and high rates of recurrent infection have limited the treatment options, necessitating more effective therapeutics that target the pathogenic mechanism of C. difficile (5-7).Toxin A (TcdA) and toxin B (TcdB), with molecular masses of 308 kDa and 270 kDa, respectively, are the two primary virulence factors secreted by C. difficile, and can inactivate the Rho/Ras superfamily of GTPases by glucosylation (8-10). As Rho GTPases regulate a number of vital cellular processes, their functional inactivation results in the inhibition of cell migration, morphogenesis, division, and membrane trafficking. Glucosylation of Rho family GTPases causes breakdown of the actin cytoskeleton and activation of caspase-3, leading to apoptosis of intoxicated cells. Diarrhea and inflammation ensue, and ultimately, the control of intestinal epithelial barrier function is lost (11-15). Much of the pathology seen during a C. difficile infection is believed to be due to toxin effects. TcdA exhibits many pathobiological functions, such as cell roundin...