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Vibrio cholerae O1 causes cholera, and cholera toxin, the principal mediator of massive diarrhea, is encoded by ctxAB in the cholera toxin (CTX) prophage. In this study, the structures of the CTX prophage region of V. cholerae strains isolated during the seventh pandemic wave 1 in Asian countries were determined and compared. Eighteen strains were categorized into eight groups by CTX prophage region-specific restriction fragment length polymorphism and PCR profiles and the structure of the region of a representative strain from each group was determined by DNA sequencing. Eight representative strains revealed eight distinct CTX prophage regions with various combinations of CTX-1, RS1 and a novel genomic island on chromosome I. CTX prophage regions carried by the wave 1 strains were diverse in structure. V. cholerae strains with an area specific CTX prophage region are believed to circulate in South-East Asian countries; additionally, multiple strains with distinct types of CTX prophage region are co-circulating in the area. Analysis of a phylogenetic tree generated by single nucleotide polymorphism differences across 2483 core genes revealed that V. cholerae strains categorized in the same group based on CTX prophage region structure were segregated in closer clusters. CTX prophage region-specific recombination events or gain and loss of genomic elements within the region may have occurred at much higher frequencies and contributed to producing a panel of CTX prophage regions with distinct structures among V. cholerae pathogenic strains in lineages with close genetic backgrounds in the early wave 1 period of the seventh cholera pandemic., (© 2018 The Authors. Microbiology and Immunology published by The Societies and John Wiley & Sons Australia, Ltd.)

Cholera occurs in sporadic cases and outbreaks in Nepal each year. Vibrio cholerae O1 (n = 522) isolated during 2007-2010 from diarrheal patients at 10 different hospital laboratories in Nepal were characterized. Biochemical and serologic identifications showed that all the isolates belonged to serogroup O1, El Tor biotype. Except 72 isolates of Inaba serotype isolated in the year 2007, all the remaining isolates were of Ogawa serotype. All isolates were resistant to nalidixic acid and furazolidone. Resistance to tetracycline, ciprofloxacin, erythromycin and co-trimoxazole were 21, 4, 16 and 90 % respectively. Seventy-seven of these isolates were selected for further characterization for ctxB gene and MLVA typing. Two different variants of classical type cholera toxin were observed. Ogawa strains from 2007 and 2010-Western Nepal outbreak harbored CTX-3 type cholera toxin, whereas Inaba serotypes in 2007 and the remaining Ogawa serotypes in 2008-2010 harbored CTX 3b-type toxin. MLVA analysis showed circulation of four different groups of altered V. cholerae O1 El Tor strains. Two different profiles were seen among 2007 Inaba (9, 3, 6, x, x) and Ogawa (10, 7, 6, x, x) isolates. The MLVA profile of 2008 and 2009 Ogawa isolates were similar to those of Inaba strains of 2007. Isolates from 2010 also showed three different MLVA profiles; profile 9, 3, 6, x, x in 3 isolates, 11, 7, 6, x, x among 2010 Western Nepal outbreak strains and profile 8, 3, 6, x, x among isolates from Butwal and Kathmandu.

Considering the recent emergence of "hybrid biotype" and "El Tor variant", we propose to redefine the biotyping scheme for Vibrio cholerae O1 serogroup. The existing biotyping scheme has limitations and causes confusion as many of the hybrid biotype and El Tor variant strains have phenotypic and genetic changes. A revised biotyping scheme will play a significant role to understand the ecology, epidemiology and nature of infection of V. cholerae O1 strains in future.

We determined the types of cholera toxin (CT) produced by a collection of 185 Vibrio cholerae O1 strains isolated in Bangladesh over the past 45 years. All of the El Tor strains of V. cholerae O1 isolated since 2001 produced CT of the classical biotype, while those isolated before 2001 produced CT of the El Tor biotype.

We report sporadic cases of a severe gastroenteritis associated with Vibrio cholerae serogroup O141. Like O1 and O139 serogroup strains of V. cholerae isolated from cholera cases, the O141 clinical isolates carry DNA sequences that hybridize to cholera toxin (CT) gene probes. The CT genes of O1 and O139 strains are carried by a filamentous bacteriophage (termed CTX phage) which is known to use toxin-coregulated pili (TCP) as its receptor. In an effort to understand the mechanism of emergence of toxigenic O141 V. cholerae, we probed a collection of O141 clinical and environmental isolates for genes involved in TCP production, toxigenicity, virulence regulation, and other phylogenetic markers. The collection included strains isolated between 1964 and 1995 from diverse geographical locations, including eight countries and five U.S. states. Information collected about the clinical and environmental sources of these isolates suggests that they had no epidemiological association. All clinical O141 isolates hybridized to probes specific for genes encoding CT (ctx), zonula occludens toxin (zot), repetitive sequence 1 (RS1), RTX toxin (rtxA), the major subunit of TCP (tcpA), and the essential regulatory gene that controls expression of both CT and TCP (toxR). In contrast, all but one of the nonclinical O141 isolates were negative for ctx, zot, RS1, and tcpA, although these strains were positive for rtxA and toxR. The one toxigenic environmental O141 isolate was also positive for tcpA. Ribotyping and CT typing showed that the O141 clinical isolates were indistinguishable or closely related, while a toxigenic water isolate from Louisiana showed a distantly related ribotype. Nonclinical O141 isolates displayed a variety of unrelated ribotypes. These data support a model for emergence of toxigenic O141 that involves acquisition of the CTX phage sometime after these strains had acquired the pathogenicity island encoding TCP. The clonal nature of toxigenic O141 strains isolated from diverse geographical locations suggests that the emergence is a rare event but that once it occurs, toxigenic O141 strains are capable of regional and perhaps even global dissemination. This study stresses the importance of monitoring V. cholerae non-O1, non-O139 serogroup strains for their virulence gene content as a means of assessing their epidemic potential.

An improved synthetic medium (M4) comprising syncase medium supplemented with sodium chloride (1%) and sucrose (0.5%) pH adjusted to 7.4 was developed for a better production of the new cholera toxin (NCT). The culture filtrates prepared in the M4 medium caused significantly (P > 0.05) more fluid accumulation than that in syncase medium. Crude toxin, prepared in the M4 medium with V. cholerae O1 strains (X-392 and 2740-80) caused a reaction similar to that of the same amount of NCT (32 micrograms) prepared in the syncase medium. The neutralization of the optimal loop reacting dose of the NCT prepared in the M4 medium by anti-NCT raised against syncase prepared toxin indicates the release of the same kind of toxin in both media. These observations indicate that the modified M4 medium may be used for NCT preparation and further characterization. All the strains of Vibro cholerae O139 used in this study produced a toxin antigenically similar to NCT.

It has been reported that cholera toxin B subunit (CTb) is a sensitive neuronal tracer with unique features. However, the possible uptake of CTb by non-terminal fibers passing through the injection site has not been examined thoroughly. In the present study, small iontophoretic injections (current = +2 microA) of CTb were made in the olivocerebellar pathway in the rat ventrolateral medulla. A large number of retrogradely labeled neurons were seen in the contralateral inferior olive. In addition, prominent anterogradely labeled climbing fibers/terminals were found in the cerebellum ipsilateral to the injection site. This study, in contrast to previous report(s), indicates that CTb can be taken up avidly by fibers of passage and transported both anterogradely and retrogradely.

Application of low concentrations (pM-nM) of NGF to mouse dorsal root ganglion (DRG)-spinal cord explants in long-term organotypic cultures rapidly prolongs the duration of the Ca(2+)-dependent component of the action potential (APD) in a major subset of DRG neurons that were previously shown to have characteristic responsiveness to exogenous opioids. These NGF-elicited excitatory modulating effects are blocked by pretreatment of the DRG neurons with monoclonal antibodies to rodent NGF receptors. NGF-induced APD prolongation is also prevented by the opioid receptor antagonist naloxone and the specific kappa-opioid antagonist nor-binaltorphimine (but not by specific mu- and delta-opioid antagonists). The results suggest that NGF stimulates the release of endogenous opioids (e.g., dynorphin) from DRG neurons and that prolongation of the APD occurs secondarily by activation of excitatory kappa-opioid receptor functions on these same or nearby cells. NGF-induced release of small quantities of opioids by DRG neurons would be expected to prolong the APD in view of the remarkable sensitivity of these neurons to the excitatory effects of extremely low (fM-nM) concentrations of exogenous opioid agonists. NGF-induced APD prolongation is blocked by the same cholera toxin A or B subunit treatments previously shown to block Gs coupling and GM1 ganglioside regulation of excitatory opioid receptors, respectively. These in vitro studies suggest that excitatory opioid receptor-mediated functions may play a role in mediating some types of rapid NGF-induced hyperalgesic and other physiologic effects on the nervous system.

Subdivision of V. cholerae 01 into toxins on the basis of the whole complex of signs characteristic of this species does not make it possible to judge on their epidemic importance and to use the data on identification of V. cholerae for solving practical problems. Classification of V. cholerae by their capacity for producing toxin (choleragen and hemolysin of type 1, subtype beta) removes these difficulties.

In a previous publication, it was reported that the pretreatment of mouse spleen cells with cholera toxin (CT) greatly inhibited their natural killer (NK) cytotoxicity. In the present study, it was found that ganglioside GM1 blocked the inhibitory effect of CT, and mature T cells and nylon-wool-adherent cells were not involved in the CT-mediated inhibition of NK cytotoxicity. It was also demonstrated that subunit A or B dissociated from CT lacked the capacity to inhibit NK cytotoxicity. In addition, CT-mediated inhibition was persistent and irreversible. The implications of CT-mediated inhibition of NK cytotoxicity are discussed.

The immunogenicity and safety of purified cholera toxin (CT), its B subunit, and a crude culture filtrate of toxigenic Vibrio cholerae (CrT) were compared in dogs immunized orally and challenged with virulent V. cholerae. CT and CrT caused marked protection in two- or three-dose regimens. Protection due to CT occurred only with doses that caused transient, sometimes severe, diarrhea in most dogs; this protection was proportional to the peak antitoxin response in jejunal mucosa and lasted at least 15 weeks. In contrast, minimum protective doses of CrT contained much less cholera toxin, caused very mild diarrhea in only 21% of the dogs, and evoked protection that was greater than predicted from the modest jejunal antitoxin response. B subunit caused smaller jejunal antitoxin responses than did similar doses of CT and was poorly protective, the 50% protective dose being >40-fold greater than that of CT. Two observations indicated that protection due to CrT involved synergy between antibacterial and antitoxic immune responses. First, the 50% protective dose of CrT was 24-fold and >36-fold smaller than the 50% protective doses of its CT and non-CT antigenic components, respectively, when tested separately. Second, protection was greater in CrT-immunized dogs than in CT-immunized dogs for a given mucosal antitoxin response. Low doses of CrT evoked serotype-specific protection, indicating that the serotype-specific O somatic antigen contributed significatly to antibacterial protection. These results suggest that a simple, effective, nonliving oral vaccine for cholera based on combined antibacterial and antitoxic immunity can probably be achieved. However, further studies are needed to determine how a protective antitoxic response can be evoked without causing diarrhea during immunization.