Additional Site for the Action of Cholera Toxin

Abstract

ASIATIC cholera is a disease of the gastrointestinal tract and its cardinal symptom is “rice-water” diarrhoea. The primary site of pathology is the intestinal canal where electrolytes and fluid are poured in the lumen and lost to the body. Primary systemic effects, if any, play little part in the pathogenesis of cholera. The gastrointestinal tract has naturally been the target of study for the action of cholera toxins^1–3. Greenough⁴, however, provided strong evidence for the involvement of the duodenum by demonstrating that the aspiration of the duodenal contents in cholera patients reduced the diarrhoeal volume. Finkelstein et al.⁵ found in infant rabbits⁶ that the caecum is unresponsive to cholera toxin, while Leitch and Burrows⁷ found the colon of rabbit unresponsive to cholera toxin. Surprisingly enough, no studies have been carried out on the stomach, probably because no vibrio can survive in the acidic conditions of the stomach.