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Updated: Sep 3, 2025
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
Stool Interleukin-1β Differentiates Clostridioides difficile Infection (CDI) From Asymptomatic Carriage and Non-CDI
Javier A Villafuerte Gálvez1,2, Nira R Pollock2,3,4, Carolyn D Alonso2,3
1Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Interleukin-1 beta (IL-1β) in stool effectively distinguishes Clostridioides difficile infection (CDI) from asymptomatic carriers and non-CDI diarrhea. This proinflammatory cytokine shows promise as a diagnostic biomarker for CDI.
Area of Science:
- Medical Microbiology
- Immunology
- Gastroenterology
Background:
- Clostridioides difficile infection (CDI) diagnosis and understanding have advanced, yet distinguishing infection from colonization remains challenging.
- The CDI colonization-infection continuum presents an unmet clinical need for accurate differentiation.
Purpose of the Study:
- To identify novel biological markers for differentiating CDI from asymptomatic carriers (ASC) and non-CDI diarrhea (NCD).
- To explore the relationship between stool cytokines, antitoxin antibodies, toxin concentrations, and disease severity in CDI.
Main Methods:
- Stool samples from CDI, NCD, ASC, and hospital control (CON) cohorts were analyzed for cytokines and antitoxin antibodies.
- Nucleic acid amplification tests (NAAT) were used to confirm CDI status.
- Receiver operating characteristic (ROC) curve analysis was employed to assess biomarker performance.
Main Results:
- Stool interleukin (IL)-1β, immunoglobulin A (IgA), and immunoglobulin G (IgG) anti-toxin A were significantly higher in CDI compared to ASC.
- IL-1β demonstrated high diagnostic accuracy (ROC-AUC = 0.88) for CDI versus ASC.
- A model combining IL-1β and IgA achieved an ROC-AUC of 0.93, and IL-1β alone differentiated CDI from NCD and controls.
Conclusions:
- Stool IL-1β is a promising biomarker for differentiating CDI from asymptomatic carriage and NCD.
- IL-1β levels correlate positively with toxin concentrations in CDI but not in asymptomatic carriers.
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