A new study found that even common pain relievers may promote infections caused by C. difficileC.difficile causes the most common and most dangerous hospital-born infections in the U.S. and around the world.

For the study, researchers from Vanderbilt University School of Medicine observed two groups of antibiotic-treated mice for a week after infection with C. difficile. They treated one group with a non-steroidal anti-inflammatory drug (NSAID) called indomethacin before infection, while the other group did not receive any treatment. NSAIDs such as ibuprofen, naproxen, and indomethacin are drugs commonly used to relieve pain and reduce inflammation.

The results showed that only 20 percent of the mice treated with NSAID survived until the end of the study period while nearly 80 percent of the mice that were not exposed to NSAID lived. The researchers also observed that even a brief exposure to NSAID before C. difficile infection increased the severity of infection and shortened the mice’s survival.

When the researchers carried out further cellular and genetic analyses, they found that NSAID exposure changed the gut microbiota of mice and reduced the production of prostaglandins which are hormone-like substances that play an important role in gut health. These findings aligned with those of earlier studies suggesting that NSAIDs can cause or worsen an inflammatory disease called colitis by suppressing the body’s production of prostaglandins.

Based on their findings, the researchers concluded that NSAID worsened C. difficile infections in mice by altering the gut microbiota, impairing epithelial cells – the main defense system in the intestine – and disrupting the normal immune response. These findings, which were published in the journal mBio, shed new light on how NSAIDs affect the severity of C. difficile infection.

David Aronoff, leader of the study and a microbiologist and infectious diseases expert at Vanderbilt University, said, “Ultimately, these new results might guide how we treat people with C. diff, particularly with pain management. Right now, it’s too early for our results to guide clinical care, but they should be a stimulus for future studies.”

Aronoff also suggested that the study’s findings might extend to other common pain relievers such as ibuprofen and aspirin because they all have almost the same biological mechanism.

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