ACTIVATION OF CLOSTRIDIUM-PERFRINGENS CYTOTOXIC ENTEROTOXIN(S) IN-VIVO AND IN-VITRO - ROLE IN TRIGGERS FOR SUDDEN INFANT DEATH

The action of Clostridium perfringens cytotoxic enterotoxins may be ac tivated/exacerbated both in vivo and in vitro by the addition of an ac tivator molecule present in a brush border membrane fraction isolated from young rabbits. Increased concentrations of the activator could be induced by immunologically stimulating rabbits with Ribi adjuvant. Co mparative studies suggested that the activator was interferon-gamma (I FN-gamma). In vitro IFN-gamma sensitized cell lines apparently by enha ncement of cell permeability, which allowed a more rapid uptake of the toxins, resulting in cell death at lower toxin concentrations. Viral and/or bacterial infections are inducers of IFNs. We propose that some immunologically immature infants are predisposed to infection. In the weeks prior to death, these infants may suffer from an infection that induces the synthesis of IFNs, sensitizing the infant to a more virul ent infection and possible sudden death.