title: Travellers' diarrhoea: prospects for successful immunoprophylaxis.
abstract: Enterotoxigenic Escherichia coli (ETEC) are the major aetiological agent of travellers' diarrhoea, usually accounting for 30-60% of cases. Thus a safe and effective vaccine against ETEC could play an important role in prevention of this infection. A successful vaccine must somehow protect against a heterogenous array of ETEC pathogens comprising many O:H serotypes and three enterotoxin phenotypes (LT+/ST-, LT-/ST+, and LT+/ST+). Three major approaches to vaccine development are currently in progress including: 1) LT and ST toxoids that stimulate antitoxic immunity; 2) purified pili vaccines that induce anti-adhesion immunity; 3) attenuated strains (prepared by recombinant DNA techniques) that mimic natural infection by stimulating antibacterial and anti-adhesive immunity as well as antitoxic immunity. Since Shigella represents the second most common cause of travellers' diarrhoea, immunoprophylaxis against this pathogen is also desirable. A recently described attenuated Salmonella typhi strain (Ty21a) expressing Shigella sonnei O antigen on its surface represents an attractive Shigella vaccine prototype.
mesh_terms: D000328:Adult; D000818:Animals; D000942:Antigens, Bacterial / Q000276:immunology; D003967:Diarrhea / Q000276:immunology / Q000628:therapy*; D004768:Enterotoxins / Q000627:therapeutic use; D004926:Escherichia coli / Q000276:immunology; D036781:Fimbriae Proteins; D010861:Fimbriae, Bacterial / Q000276:immunology; D006801:Humans; D007109:Immunity; D007167:Immunotherapy / Q000639:trends*; D012760:Shigella / Q000276:immunology; D014195:Travel; D014612:Vaccines / Q000276:immunology
chemical_list: D000942:Antigens, Bacterial; D004768:Enterotoxins; D014612:Vaccines; C022924:colonization factor antigens; D036781:Fimbriae Proteins