Flagellar switch inverted repeats impact heterogeneity in flagellar gene expression and thus C. difficile RT027/MLST1 virulence Journal Article


Authors: Nhu, N. T. Q.; Lin, H.; Pigli, Y.; Sia, J. K.; Kuhn, P.; Ruppel, H.; Snitkin, E. S.; Young, V. B.; Kamboj, M.; Pamer, E. G.; Rice, P. A.; Shen, A.; Dong, Q.
Article Title: Flagellar switch inverted repeats impact heterogeneity in flagellar gene expression and thus C. difficile RT027/MLST1 virulence
Abstract: Clostridioides difficile (C. difficile) RT027 strains cause infections that vary in severity from asymptomatic to lethal, but the molecular basis for this variability is poorly understood. Through comparative analyses of RT027 clinical isolates, we determine that isolates that exhibit greater heterogeneity in their flagellar gene expression exhibit greater virulence in vivo. C. difficile flagellar genes are phase-variably expressed due to the site-specific inversion of the flgB 5′ UTR region, which reversibly generates ON vs. OFF orientations for the flagellar switch. We find that longer inverted repeat (IR) sequences in this switch region correlate with greater disease severity, with RT027 strains carrying 6A/6T IR sequences exhibiting greater phenotypic heterogeneity in flagellar gene expression (60%–75% ON) and causing more severe disease than those with shorter IRs (>99% ON or OFF). Our results reveal that phenotypic heterogeneity in flagellar gene expression may contribute to the variable disease severity observed in C. difficile patients. © 2025 The Author(s)
Keywords: controlled study; gene mutation; diarrhea; nonhuman; mouse; phenotype; gene expression; animal experiment; animal model; genetic variability; in vivo study; bacterial virulence; real time polymerase chain reaction; clostridium difficile infection; genetic heterogeneity; bacterium isolation; linear regression analysis; colony forming unit; recombinase; virulence; inverted repeat; body weight loss; sanger sequencing; article; whole genome sequencing; rna sequencing; inverted repeats; clostridioides difficile; cp: microbiology; rt027; flagellar switch; clostridioides difficile rt027 mlst1; flagellar gene expression; flagellar switch inverted repeat
Journal Title: Cell Reports
Volume: 44
Issue: 6
ISSN: 2211-1247
Publisher: Cell Press  
Date Published: 2025-06-24
Start Page: 115830
Language: English
DOI: 10.1016/j.celrep.2025.115830
PROVIDER: scopus
PUBMED: 40504685
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Mini Kamboj
    159 Kamboj
  2. Jonathan Kevin Sia
    4 Sia