Correlation of fecal cAMP with fluid loss in cholera

Abstract

Adenosine 3′,5′-cyclic monophosphate (cAMP) has been suggested to mediate in the intestinal secretory mechanism in cholera (1–3). cAMP appears to affect intestinal ion transport processes at two separate sites, namely villus cells and crypt cells (4). In villus cells, cAMP inhibits coupled NaCl exchange across the brush border and in crypt cells, cAMP stimulates active anion secretion (4). Fecal sodium excretion has been shown to increase with the rate of fluid loss as measured by fecal volume in milliliters per hour (5). Changes in fluid and electrolyte movement are associated with increased mucosal permeability in in vivo situations (6,7) and thus may allow cAMP to be excreted into the feces. The present study is intended to investigate the correlation of fecal cAMP excretion with the rate of fluid loss in cholera patients with a view to establish a probable model for interpreting intestinal secretory response without measuring mucosal cAMP.