Phosphatidylcholine and the intestinal mucus layer: in vitro efficacy against Clostridium difficile-associated polymorphonuclear neutrophil activation

BackgroundPhosphatidylcholine (PC), an important component of intestinal mucus, protects against Clostridium difficile toxin-induced intestinal barrier injury in vitro. Polymorphonuclear neutrophil (PMN) activation may contribute to intestinal injury and systemic toxicity in patients with C. difficile-associated disease. We therefore hypothesized that the intestinal barrier function against C. difficile toxin by exogenous PC would ameliorate PMN activation.MethodsIntestinal epithelial cell (IEC) monolayers were cocultured with C. difficile toxin A and/or exogenous PC. Naïve PMNs were cocultured with IEC culture supernatants and PMN activation, and chemotactic potential determined.ResultsPC treatment of IEC abrogated the enhanced PMN activation and chemotactic potential following toxin A exposure (P < .001).ConclusionsExogenous PC ameliorated PMN activation from IECs exposed to C. difficile toxin. Administration of exogenous PC may be a useful adjunctive treatment in severely ill or immunocompromised patients with C. difficile-associated disease.