As the study says, the direct cause is high intestinal levels of calcium but as the study also says these are usually due to poor calcium absorption. And unless a person has IBD (which is rare) the low vitamin D status or PPI drug (GERD) use stand out as the most likely causes, even more so considering how prevalent both vitamin D deficiency and PPI use is. The study seems to vindicate glycine, which up until now was apparently considered crucial for establishment of C. difficile infection.
The same mechanism seems to be at play in other severe gut bacteria infections including the one now officially claimed to be the cause of Chron's disease - Mycobacterium paratuberculosis (Mycobacterium avium subspecies paratuberculosis - Wikipedia). Ray has spoken many times about the role of low vitamin D in chronic inflammatory conditions including IBD and this study seems to confirm his position. Yet another reason to ensure optimal levels, which seems to be in the 50 - 60 range. And whoever is using PPI may want to consider switching to the safer H2 antagonists like famotidine. The link between PPI and gut infection/inflammation is really scary as these drugs are commonly prescribed to pretty much everybody who endures a hospital stay and most people acquire C. difficile infection at a hospital.
Hey, @aguilaroja you may want to take a look at this as it is another black mark for the PPI drugs.
Intestinal calcium and bile salts facilitate germination of Clostridium difficile spores
‘Superbug’ may depend on calcium to multiply
"...Clostridium difficile (known as “C. diff”) bacterial infections are commonplace in hospitals and nursing homes. C. diff is responsible for large numbers of deaths every year and is the leading cause of hospital-acquired diarrhea."
"...The researchers suggested that individuals with high gut levels of calcium could be at higher risk for C. diff infection. High intestinal calcium may be the result of supplementation, poor absorption resulting from low vitamin D status, medication use (including Proton Pump Inhibitors (PPIs)), or gut diseases such as Crohn’s or colitis. The researchers noted that all the individual elements above are established risk factors for C. diff infection and critically, that “deficient intestinal calcium absorption (i.e., increased calcium levels) is associated with these risk factors.” However, Hanna advocates caution to patients considering ceasing medications or doctor–recommended supplements (or starting new ones). Nevertheless, avoiding excess calcium and ensuring adequate vitamin D status appear prudent in the light of the findings. The discovery that calcium germinates C. diff spores is also significant; as the amino acid, glycine was previously thought necessary to the process. This study demonstrated that spore germination could occur without glycine. Travis Kochan, a graduate student in the research team, observed that the liquid used for growing C. diff for their studies contained calcium. When he chemically removed calcium from the growth medium, spore germination ceased. FDA researchers subsequently conducted further research in mice using C. diff spores modified to prevent glycine acting upon them. As spore germination still occurred without glycine, this demonstrated that calcium was the critical trigger."
The same mechanism seems to be at play in other severe gut bacteria infections including the one now officially claimed to be the cause of Chron's disease - Mycobacterium paratuberculosis (Mycobacterium avium subspecies paratuberculosis - Wikipedia). Ray has spoken many times about the role of low vitamin D in chronic inflammatory conditions including IBD and this study seems to confirm his position. Yet another reason to ensure optimal levels, which seems to be in the 50 - 60 range. And whoever is using PPI may want to consider switching to the safer H2 antagonists like famotidine. The link between PPI and gut infection/inflammation is really scary as these drugs are commonly prescribed to pretty much everybody who endures a hospital stay and most people acquire C. difficile infection at a hospital.
Hey, @aguilaroja you may want to take a look at this as it is another black mark for the PPI drugs.
Intestinal calcium and bile salts facilitate germination of Clostridium difficile spores
‘Superbug’ may depend on calcium to multiply
"...Clostridium difficile (known as “C. diff”) bacterial infections are commonplace in hospitals and nursing homes. C. diff is responsible for large numbers of deaths every year and is the leading cause of hospital-acquired diarrhea."
"...The researchers suggested that individuals with high gut levels of calcium could be at higher risk for C. diff infection. High intestinal calcium may be the result of supplementation, poor absorption resulting from low vitamin D status, medication use (including Proton Pump Inhibitors (PPIs)), or gut diseases such as Crohn’s or colitis. The researchers noted that all the individual elements above are established risk factors for C. diff infection and critically, that “deficient intestinal calcium absorption (i.e., increased calcium levels) is associated with these risk factors.” However, Hanna advocates caution to patients considering ceasing medications or doctor–recommended supplements (or starting new ones). Nevertheless, avoiding excess calcium and ensuring adequate vitamin D status appear prudent in the light of the findings. The discovery that calcium germinates C. diff spores is also significant; as the amino acid, glycine was previously thought necessary to the process. This study demonstrated that spore germination could occur without glycine. Travis Kochan, a graduate student in the research team, observed that the liquid used for growing C. diff for their studies contained calcium. When he chemically removed calcium from the growth medium, spore germination ceased. FDA researchers subsequently conducted further research in mice using C. diff spores modified to prevent glycine acting upon them. As spore germination still occurred without glycine, this demonstrated that calcium was the critical trigger."