Abstract
Enterotoxigenic Escherichia coli (ETEC) is a major diarrheal pathogen that encodes two enterotoxins, the heat-labile toxin (LT) and the heat-stable toxin (ST). Each toxin alone is sufficient to cause diarrheal disease, but many wild ETEC isolates carry both enterotoxins. Motyka et al. (e00707-20) show that ST modulates host epithelial physiology and the epithelial-immune axis. ST intoxication causes extracellular and luminal cGMP accumulation and alteration of epithelial type 1 cytokine expression, including nuclear alarmin IL-33. ETEC immunization studies also show that ST suppresses LT-based adjuvanted mucosal IgA, suggesting that two toxins act synergistically to help ETEC to evade host immune responses.
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