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Toxins and the gut: role in human disease

Correspondence to:
Correspondence to:
Dr A Fasano, Division of Pediatric Gastroenterology and Nutrition, University of Maryland School of Medicine, 685 W Baltimore St HSF Building, Room 465, Baltimore, MD 21201, USA;
afasano{at}umaryland.edu

ABSTRACT
Bacterial enteric infections exact a heavy toll on the human population, particularly among children. Despite the explosion of knowledge on the pathogenesis of enteric diseases experienced during the past decade, the number of diarrhoeal episodes and human deaths reported worldwide remains of apocalyptic dimensions. However, our better understanding of the pathogenic mechanisms involved in the onset of diarrhoea is finally leading to preventive interventions, such as the development of enteric vaccines, that may have a significant impact on the magnitude of this human plague. The application of a multidisciplinary approach to study bacterial pathogenesis, along with the recent sequencing of entire microbial genomes, have made possible discoveries that are changing the way scientists view the bacterium–host interaction. Today, research on the molecular basis of the pathogenesis of infective diarrhoeal diseases of necessity transcends established boundaries between microbiology, cell biology, intestinal pathophysiology, and immunology. This review focuses on the most recent outcomes of this multidisciplinary effort.

Keywords: toxin; infection; bacteria

Abbreviations: ANP, atrial natriuretic peptide; BFT, B fragilis enterotoxin; CPE, C perfringens enterotoxin; CT, cholera toxin; CTC, V cholerae cytolysin; EAggEC, enteroaggregative E coli; ETEC, enterotoxigenic E coli; LPS, lipopolysaccharide; GC, guanylate cyclase; LT, heat labile toxin; PET, plasmid encoded protein; PKC, protein kinase C; ShET, Shigella enterotoxin; ST, heat stable toxin; TDH, thermostable direct haemolysin

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