Journal
JOURNAL OF CLINICAL INVESTIGATION
Volume 124, Issue 10, Pages 4166-4172Publisher
AMER SOC CLINICAL INVESTIGATION INC
DOI: 10.1172/JCI72334
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Funding
- NIH [R01CA151393, R21CA170492, R01CA151325, R01CA179440]
- Merieux Institute
- Johns Hopkins GI SPORE in Gastrointestinal Cancers (Career Development Program) [P50CA062924]
- Johns Hopkins Immunology Training Program
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The human body comprises fewer host cells than bacterial cells, most of which are obligate anaerobes residing in the gut. The symbiont Bacteroides fragilis constitutes a relatively small proportion (up to 1%-2%) of cultured fecal bacteria, but colonizes most humans. There are 2 classes of B. fragilis distinguished by their ability to secrete a zinc-dependent metalloprotease toxin, B. fragilis toxin (BFT). Strains that do not secrete BFT are nontoxigenic B. fragilis (NTBF), and those that do are called enterotoxigenic B. fragilis (ETBF). ETBF can induce clinical pathology, including inflammatory diarrhea, although asymptomatic colonization may be common. Intestinal inflammation is mediated by BFT, as yet the only known virulence factor of ETBF. Recent experimental evidence demonstrating that ETBF-driven colitis promotes colon tumorigenesis has generated interest in the potential contribution of ETBF to human colon carcinogenesis. Critical questions about the epidemiology of chronic, subclinical human colonization with ETBF and-its impact on the biology of the colon need to be addressed.
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