Montero David A, Vidal Roberto M, Velasco Juliana, George Sergio, Lucero Yalda, Gómez Leonardo A, Carreño Leandro J, García-Betancourt Richard, O'Ryan Miguel
Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile.
Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Front Med (Lausanne). 2023 May 5;10:1155751. doi: 10.3389/fmed.2023.1155751. eCollection 2023.
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 as well as provide an overview of the immune response against this pathogen. We highlight that 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 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 and identifies knowledge gaps that must be addressed to develop more effective cholera vaccines.
是霍乱的病原体，霍乱是一种高度传染性的腹泻疾病，每年影响全球数百万人。霍乱是一个主要的公共卫生问题，主要存在于卫生条件差的国家以及受自然灾害影响的地区，这些地区安全饮用水的获取有限。在这篇叙述性综述中，我们旨在总结目前对霍乱弧菌毒力和发病机制演变的认识，并概述针对这种病原体的免疫反应。我们强调霍乱弧菌具有显著的适应和进化能力，这是一个全球关注的问题，因为它增加了霍乱暴发的风险以及疾病传播到新地区的可能性，使得霍乱的控制更具挑战性。此外，我们表明这种病原体表达多种毒力因子，使其能够有效地在人类肠道定殖并引发霍乱。一系列累积的研究还表明，霍乱弧菌感染会引发炎症反应，影响针对霍乱的免疫记忆的形成。最后，我们回顾了已获许可的霍乱疫苗的状况、正在进行临床评估的疫苗以及下一代疫苗研发的最新进展。这篇综述提供了对霍乱弧菌的全面看法，并确定了开发更有效的霍乱疫苗必须解决的知识空白。
