Diarrheal diseases affect millions of people, and 2.5 million children under the age of 5 years die from these diseases every year (1). Diarrheal disease develops through a multifactorial process that counteracts the net absorption of water as the result of an increase in the secretion or a decrease in the absorption of water. In the intestinal tract, the passage of water across the epithelial barrier is tightly regulated by both the transcellular and paracellular movements of fluid and electrolytes. Transcellular passage develops through an asymmetric intracellular distribution of membrane-associated pumps and channels, whereas paracellular permeability is regulated by structural and functional proteins located at the tight junctions (TJs) (2). Enteric bacterial pathogens have developed sophisticated strategies to manipulate the host's normal water balance by producing both structural and functional changes in the epithelial barrier (3). In particular, enterovirulent Escherichia coli strains alter the structural organization of polarized epithelial cells and/or deregulate the functional systems involved in the regulation of the transcellular or paracellular passage of fluids and electrolytes in the intestinal epithelial barrier by the production of deleterious cytotoxic or cytotonic toxins (3).The gastrointestinal system uses a variety of antisecretory or proabsorptive hormonal and protein agonists to balance the outflow of fluid and electrolytes. Those that have been more extensively studied are neuropeptide Y/peptide YY (NPY/PYY) (4) and antisecretory factor (AF) (5). AF is a 41-kDa endogenous protein which was originally purified from the pig pituitary gland by Lön-nroth and Lange (6). Its gene has been cloned and sequenced (7). AF is phylogenetically well preserved, since it appears to be a single protein with several conformational variants (8), and no AF-like proteins have been reported. AF is present in most tissues, including the nasal, respiratory, urinary, and gastrointestinal mucosae (9, 10), and is secreted into plasma and other tissue fluids in mammals (11-13). AF appears in rat tissues after a challenge with cholera toxin (CT) or Clostridium difficile toxin (CDT) (14-16). A region of AF that supports its antisecretory activity has been identified between residues 36 and 51, located in the N-terminal part of the full-length protein (14,(17)(18)(19)(20). Experimentally, AF inhibits the intestinal secretion of fluids induced by a variety of toxins, including CT (6,7,14,17,[21][22][23][24][25][26], Campylobacter toxin (24, 27), Escherichia coli heat-labile enterotoxin (LT) (18, 23) and heatstable enterotoxins (ST) (23,25,28), CDT (14,15,21), and Dinophysis toxin (24). Moreover, AF and the AF peptide containing the active peptide sequence from residues 36 to 51 have been shown to block the out-in permeation of 36 Cl in nerve cell membranes isolated from rabbit Dieter cells (20,29,30). Clinically, AF appears to be effective, since administration of a medicinal food containing AF-rich egg yolk powder (B2...