Citrobacter rodentium infection reveals preserved intestinal resilience in aged intestine

Ageing is generally associated with increased susceptibility to enteric infection and is widely considered to reflect progressive deterioration of intestinal function. However, whether increased susceptibility represents complete loss of intestinal resilience or a distinct host response to infection remains unclear. Using Citrobacter rodentium (CR) infection as a model of infectious colitis, we investigated how ageing shapes epithelial responses to enteric bacterial infection. Infection of aged mice with wild type CR (CRWT) resulted greater bacterial colonisation, deeper crypt localisation, impaired fluid-ion homeostasis and more severe colitis than young mice. Conversely, infection of aged mice with CRM12, a CR strain lacking 12 type III secretion system effectors, resulted in reduced epithelial colonisation, preservation of epithelial barrier function and fluid-ion homeostasis, restrained inflammatory responses, and markedly lower disease severity than CRWT infection. Deep quantitative proteomic analysis demonstrated that these divergent outcomes were accompanied by distinct adaptive molecular programmes within the aged intestinal epithelium. Together, our findings demonstrate that although aged mice exhibit increased susceptibility to enteric infection, the aged intestine retains the ability to mount distinct epithelial, inflammatory and molecular responses to pathogens with different virulence repertoires. Thus, increased susceptibility in aged mice should not be interpreted as complete loss of intestinal resilience.