Cholera enterotoxin—Recent investigations yield insights into transport processes

Abstract

From the Department of Medicine, the Baltimore City Hospitals, and the Johns Hopkins University School of Medicine, Baltimore, Maryland 21205. This work was supported by research grant Al-07625 from the National Institutes of Health, under the auspices of the United States-Japan Cooperative Medical Science Program. Requests for reprints should be addressed to Dr. Charles C. J. Carpenter, Department of Medicine, Baltimore City Hospitals, 4940 Eastern Avenue, Baltimore, Maryland 21224. Manuscript received August 20, 1970. Early studies of cholera led to the first rational use of intravenous fluid therapy [l]. Later studies in cholera patients demonstrated the value of intravenously administered bicarbonate in the correction of base-deficit acidosis [Z]. These observations made major contributions to the development of rational intravenous fluid therapy for pediatric diarrhea1 disease. The past decade has witnessed a major increase in knowledge of the pathogenesis of cholera. Impetus to increased productive research in this area has been provided by two major interrelated factors: the Seventh Cholera Pandemic (1961-1970), and the development of highly effective international cooperative medical research programs, several of which have been deeply involved in the cholera problem. Recent studies have resulted in the isolation and purification of an enterotoxin which appears to be entirely responsible for the massive fluid loss in this disease [3,4]. The knowledge gained from these studies promises to be of value not only in the prevention and treatment of cholera, but also in our understanding of normal processes of fluid and electrolyte movement across the gut and other mucosal membranes, The disease cholera results from rapid loss from the gut of an isotonic fluid which is very low in protein; this fluid has a mean bicarbonate concentration approximately twice that of normal plasma and a mean potassium concentration four times that of