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The pathogenesis of cholera is intimately associated with the production and action of the enterotoxin molecule known as cholera toxin (in earlier work sometimes called choleragen or permeability factor) by the cholera vibrios. It is now 20 years since experimental evidence first clearly suggested that cholera is a toxin-mediated disease. Robert Koch, who identified V. cholerae as the causative agent of cholera, had already proposed in 1884 that the disease was toxin-mediated1 but it was not until 1959 that the Indian scientists De2 and Dutta3 and their co-workers convincingly demonstrated the existence of the cholera toxin. Today, cholera is recognized as the prototype of a large group of diarrheal diseases that are also mediated by enterotoxins, some of which are structurally and functionally related to the cholera enterotoxin. Collectively, these other “enterotoxic enteropathies”4 are more important than cholera as causes of morbidity and mortality in most parts of the world. Still, however, the main information about the pathogenesis of this whole group of diseases was derived from basic research about the pathogenesis of cholera and to a large extent to specific studies of the cholera toxin molecule and its mode of action.
KeywordsAdenylate Cyclase Cholera Toxin Vasoactive Intestinal Polypeptide Enteric Nervous System Intestinal Epithelial Cell Line
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