# Regulation of C. difficile infection by the cytokine interleukin-22 (IL-22)

> **NIH NIH P20** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $254,377

## Abstract

PROJECT SUMMARY 
Clostridioides difficile is a mucosal-associated pathogen that can cause life-threatening illness. The bacterium 
is a leading source of hospital-acquired GI infections, but is emerging in the healthy population. Asymptomatic 
colonization is common and only leads to productive infection in some individuals, and a subset of these 
patients will have a relapsing, more severe disease. C. difficile secretes toxin B (TcdB), an inactivator of small 
GTPases that induces epithelial cell death. This toxin helps C. difficile establish the niche it needs for 
productive infection. C. difficile requires perturbation in the microbiome to initiate disease. Although recent 
studies have revealed some means of how it overcomes commensals, we still do not fully understand how C. 
difficile establishes infection or initiates re-infection. Host immune responses likely play a role. Our long-term 
goal is to identify how cytokine biology may be therapeutically targeted to alleviate initial C. difficile infection or 
relapses in high-risk patients. Group 3 innate lymphocytes (ILC3s) are rare immune cells often found in 
mucosal tissues. They produce high levels of IL-22, a critical modulator of mucosal tissue responses. IL-22 is 
important for maintaining intestinal homeostasis in health and disease. Through maintenance of the epithelial 
barrier, the cytokine is protective in GI infections, although the role of IL-22 in C. difficile infection is not clear. 
In our studies investigating interactions between toxins and ILC3s, we examined the effects of TcdB on IL-22. 
Our preliminary data show that TcdB induces IL-22 in ILC3s in a GTPase-dependent manner. Pharmacological 
inhibition suggests that upregulation of IL-22 is through Cdc42. These data form the premise for our hypothesis 
that C. difficile modulates the host immune response. The overall objective for this application is to understand 
signaling pathway(s) through which TcdB may modulate ILC3 production of IL-22 and ascertain the benefits of 
elevated IL-22 to C. difficile during infection. In Aim 1 we will examine how the small GTPase Cdc42 may 
regulate IL-22 production in activated ILC3s. Through genetic or siRNA-mediated deletion of Cdc42 in ILC3s, 
we will examine if this small GTPase is a negative regulator of ILC3 activation as well as examine if there are 
links between Cdc42 and other signaling pathways, including STAT3 and MAPKs. In Aim 2, we will examine 
the interactions between C. difficile and TcdB, and IL-22 and the GI tissues. We will examine the function of IL- 
22 signaling in C. difficile infection using a reductionist approach with colonic organoids. Studies will examine if 
IL-22 protects against TcdB-mediated apoptosis and identify which IL-22-inducible factors contribute to altering 
the niche. An in vivo C. difficile infection model will complement in vitro experiments. This study may identify 
new signaling pathways involved in regulation of IL-22, which is of inter...

## Key facts

- **NIH application ID:** 10800656
- **Project number:** 5P20GM134973-05
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Lauren A Zenewicz
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $254,377
- **Award type:** 5
- **Project period:** 2020-03-01 → 2025-08-19

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10800656

## Citation

> US National Institutes of Health, RePORTER application 10800656, Regulation of C. difficile infection by the cytokine interleukin-22 (IL-22) (5P20GM134973-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10800656. Licensed CC0.

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