Vibrio cholerae, classification, pathogenesis, immune response, and trends in vaccine development

Abstract

Vibrio cholerae is the causative agent of cholera, a highly contagious diarrheal disease affecting millions worldwide each year. Cholera is a major public health problem, primarily in countries with poor sanitary conditions and regions affected by natural disasters, where access to safe drinking water is limited. In this narrative review, we aim to summarize the current understanding of the evolution of virulence and pathogenesis of V. cholerae as well as provide an overview of the immune response against this pathogen. We highlight that V. cholerae has a remarkable ability to adapt and evolve, which is a global concern because it increases the risk of cholera outbreaks and the spread of the disease to new regions, making its control even more challenging. Furthermore, we show that this pathogen expresses several virulence factors enabling it to efficiently colonize the human intestine and cause cholera. A cumulative body of work also shows that V. cholerae infection triggers an inflammatory response that influences the development of immune memory against cholera. Lastly, we reviewed the status of licensed cholera vaccines, those undergoing clinical evaluation, and recent progress in developing next-generation vaccines. This review offers a comprehensive view of V. cholerae and identifies knowledge gaps that must be addressed to develop more effective cholera vaccines.

Multiple Endemic Equilibria in an Environmentally-Transmitted Disease With Three Disease Stages

“…These A-type individuals, when continuously exposed to the contaminated environment, give rise to an active infection form of the disease and may reverse to asymptomatic carriers after some time i.e., become A-type individuals again. Second, S-type susceptible individuals, when infected, can follow the normal illness pathway or can become infected with what we call the acute form of the disease as in cholera, tuberculosis, toxoplasmosis and Giardia [15,26,27,35]. Our main result is that the model equilibria may arise through a normal transcritical (forward) bifurcation depending only on the net increase in the level of environmental contamination determined by the threshold environmental parameter T 0 = ρ/ω, which is independent of all transmission parameters; surprisingly, it only depends on those describing the input and output flows of the contaminated environment.…”

“…An example of a bacteria that can present a variety of strains with different pathogenic qualities is Vibrio cholera. Strains of the serogroups O1 and O139 can cause the diarrheal disease; but V. cholerae bacteria belonging to other serogroups (designated non-O1, non-O139) are rather associated with gastrointestinal or extraintestinal infections [32,27]. To treat these diseases, the use of antimicrobials is widespread with different levels of success [23,24].…”

Mitogen-Activated Protein Kinases (MAPKs) and Enteric Bacterial Pathogens: A Complex Interplay

“…Vibrio cholerae is a highly contagious bacterium responsible for cholera, an acute diarrheal infection caused by ingesting contaminated food or water, affecting millions in countries with poor sanitation [134]. The pathogen expresses several essential virulence factors, enabling its efficient colonization of the human intestine.…”

“…Vibrio cholerae consists of multiple serogroups, two of which are the O1 and O139 serogroups, causing cholera outbreaks due to their ability to produce cholera toxins (CTXs) [134]. CTXs, released by the type 2 secretion system of the microbe, have two subunits, A (CTXA) and B (CTXB).…”

Total Synthesis of a Conjugation-Ready Tetrasaccharide Repeating Unit of Vibrio cholerae O:3 O-antigen Polysaccharide

“…There are a few oral cholera vaccines (OCVs) approved by WHO. However, degradation of the antigen exposed to acidic pH in the stomach and short-lived immune protection leaves room for further development for a multicomponent glycoconjugate vaccine against all O-antigen serogroups of V. cholerae . There are more than 200 serogroups based on O-antigen of the lipopolysaccharide present on the bacterial cell surface .…”