title: Acute dehydrating disease caused by Vibrio cholerae serogroups O1 and O139 induce increases in innate cells and inflammatory mediators at the mucosal surface of the gut.
abstract: OBJECTIVE
  The general concept is that as Vibrio cholerae is not invasive, it mediates a non-inflammatory type of infection. This is being re-evaluated based on available data that natural cholera infection or cholera toxin induces a Th2-type of immune profile and stimulates the humoral immune response, innate cells, and mediators in the host.
  
  
  METHODS
  To perform a comprehensive analyses of the inflammatory components, we studied mucosal biopsies from patients, both adults and children with acute watery diarrhoea caused by V cholerae O1 and O139. Patients with cholera, adults (n = 30) and children (n = 18), as well as healthy controls (n = 24) were studied. Histochemical, immunohistochemical, and ultrastructural studies were carried out to elucidate the contribution of the different factors using paraffin and frozen duodenal and/or rectal sections as appropriate. Samples were collected during the acute stage and during early and/or late convalescence.
  
  
  RESULTS
  Following natural cholera infection, patients responded with increases in neutrophil polymorphs during the acute stage (p<0.001) compared with healthy controls whereas mucosal mast cells (MMC) (p = 0.008) and eosinophils (p = 0.034) increased in the gut during convalescence. Electron microscopic analyses of duodenal biopsies from adult patients showed increased piecemeal degranulation in both MMC and eosinophils and accumulation of lipid bodies in MMC. Duodenal biopsies from V cholerae O1 infected patients showed upregulation of myeloperoxidase, lactoferrin, PGHS-1, SCF, tryptase, tumour necrosis factor alpha, alpha-defensin, and eotaxin during the acute stage and chymase, interleukin 3 and major basic protein during convalescence.
  
  
  CONCLUSIONS
  We have shown that innate cells and their mediators are upregulated in acute watery diarrhoea. These cells and factors of the innate arm may be important in the host's defence against cholera. Such effects may need to be simulated in a vaccine to achieve long lasting protection from cholera.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box 128, Dhaka 1000, Bangladesh. fqadri@icddrb.org
authors.forename: F
authors.initials: F
authors.lastname: Qadri
authors.forename: T R
authors.initials: TR
authors.lastname: Bhuiyan
authors.forename: K K
authors.initials: KK
authors.lastname: Dutta
authors.forename: R
authors.initials: R
authors.lastname: Raqib
authors.forename: M S
authors.initials: MS
authors.lastname: Alam
authors.forename: N H
authors.initials: NH
authors.lastname: Alam
authors.forename: A-M
authors.initials: AM
authors.lastname: Svennerholm
authors.forename: M M
authors.initials: MM
authors.lastname: Mathan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D002771:Cholera / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D004386:Duodenum / Q000276:immunology / Q000378:metabolism / Q000648:ultrastructure; D004804:Eosinophils / Q000648:ultrastructure; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000276:immunology* / Q000382:microbiology / Q000648:ultrastructure; D007958:Leukocyte Count; D008297:Male; D008407:Mast Cells / Q000648:ultrastructure; D008854:Microscopy, Electron; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D015854:Up-Regulation; D041241:Vibrio cholerae O1 / Q000472:pathogenicity*; D041242:Vibrio cholerae O139 / Q000472:pathogenicity*
chemical_list: D018836:Inflammation Mediators