Toxigenic strains of the anaerobic bacterium Clostridium difficile pro
duce at least two large, single-chain protein exotoxins involved in th
e pathogenesis of antibiotic-associated diarrhea and colitis. Toxin A
(CdA) is a cytotoxic enterotoxin, while toxin B (CdB) is a more potent
cytotoxin lacking enterotoxic activity. This study dealt with CdB, pr
oviding the first evidence that intestinal cells exposed to this toxin
exhibit typical features of apoptosis in that a significant proportio
n of the treated cells displayed nuclear fragmentation and chromatin c
ondensation. In keeping with ultrastructural data, CdB-treated cells s
howed the typical flow cytometric hallmark of apoptosis consisting of
a distinct sub-G, peak. The CdB-induced apoptotic response was dose an
d time dependent and not simply due to the actin-disrupting effect of
the toxin or to the subsequent impairment of cell anchorage. Rather, t
he inhibition of proteins belonging to the Rho family due to CdB seems
to play a role in the induction of apoptosis in intestinal cells. The
origin of cells and the growth rate may also be cofactors relevant to
such a response.