Following intranasal inoculation, Vibrio cholerae KFV101 (⌬ctxAB ⌬hapA ⌬hlyA ⌬rtxA) colonizes and stimulates tumor necrosis factor alpha and interleukin 1 (IL-1) in mice, similar to what occurs with isogenic strain P4 (⌬ctxAB), but is less virulent and stimulates reduced levels of IL-6, demonstrating a role for accessory toxins in pathogenesis. Morbidity is enhanced in C3H/HeJ mice, indicating that Toll-like receptor 4 is important for infection containment.Vibrio cholerae is a gram-negative pathogen that induces diarrhea dependent upon the action of the cyclic AMP-stimulating cholera toxin (CT) (11). During cholera disease, patients in the acute phase do not have extensive tissue damage such as might be observed with shigellosis (21, 22). However, low levels of infiltration of neutrophils, mast cells, and eosinophils in infection and the presence of mediators of inflammatory cell regulation on the second day of cholera disease indicate that V. cholerae stimulates a proinflammatory response early during infection (21). This inflammatory response possibly becomes excessive in the absence of genes for CT since volunteers given CT-deficient strains have significantly increased titers of lactoferrin and CXCL8, indicative of more severely inflammatory disease typified by symptoms that include vomiting, fever, mild diarrhea, and cramping (25). These symptoms are also typical of nonepidemic strains of V. cholerae that do not produce CT (4,7,10,13,16,17). This increase in the inflammatory nature of V. cholerae infection could be due to the absence of the immunomodulatory activity of the B subunit of CT that blocks the secretion of proinflammatory cytokines by macrophages, dendritic cells, and epithelial cells in response to bacterial lipopolysaccharide (LPS) (24) due to downregulation of mitogen-activated protein kinase pathways (6).A major problem with this residual disease of non-CT-producing V. cholerae is that these strains are frequently sufficiently virulent to make them unsafe for use as live attenuated vaccines (2,14,26,27). It has been proposed that the actions of accessory toxins of V. cholerae are responsible for this increased inflammation and contribute to the reactogenicity of live attenuated vaccine strains (24). Recently, we developed a murine model that is sensitive to accessory toxins and can be used to investigate early events in the initiation of the host response to non-CT-producing V. cholerae. Although adult mice are resistant to intestinal colonization by V. cholerae (12), we found that acute inflammation develops in the lung tissue after intranasal inoculation with V. cholerae, providing a model for the assessment of the toxic action on inflammation of a mucosal epithelial layer (8). This model is based on experiments using Shigella flexneri dependent on the premise that the bronchial tree is composed of a mucosal lining with relevant characteristics similar to those of the intestine, including simple cubodial-to-columnar epithelial cells, lymphoid aggregates, bronchiole-associated lymphoid ti...