Abstract
Enterotoxigenic Escherichia coli (ETEC) are a leading cause of diarrheal illness in developing countries. Despite the discovery of these pathogens as a cause of cholera-like diarrhea over 40 years ago, and decades of vaccine development effort, there remains no broadly protective ETEC vaccine. The discovery of new virulence proteins and an improved appreciation of the complexity of the molecular events required for effective toxin delivery may provide additional avenues to pursue in development of an effective vaccine to prevent severe diarrhea caused by these important pathogens.
Highlights
The enterotoxigenic Escherichia coli (ETEC) are a leading cause of diarrheal illness in developing countries where these diverse pathogens account for millions of infections and hundreds of thousands of deaths each year [1], in young children under two years of age [2,3]
While it may be important to prevent cholera-like disease to avoid deaths from diarrheal illness, the association of ETEC with delayed growth [4] and malnutrition [5,6] in developing countries could imply that an effective vaccine would have a more far-reaching impact on the health of young children at risk for these ubiquitous infections
Recent efforts to develop an labile toxin (LT)-based ETEC vaccine patch were met with partial success in that they were protective against strains that only produced this toxin [27]
Summary
The enterotoxigenic Escherichia coli (ETEC) are a leading cause of diarrheal illness in developing countries where these diverse pathogens account for millions of infections and hundreds of thousands of deaths each year [1], in young children under two years of age [2,3]. While it may be important to prevent cholera-like disease to avoid deaths from diarrheal illness, the association of ETEC with delayed growth [4] and malnutrition [5,6] in developing countries could imply that an effective vaccine would have a more far-reaching impact on the health of young children at risk for these ubiquitous infections. Understanding the precise molecular events involved in delivery of ETEC toxins could provide key insights that inform development of more effective vaccines. Dissection of the details of ETEC pathogen-host interactions has provided additional molecules that can be targeted in new iterations of ETEC vaccines
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