Pathogenesis of vibrio:The Cholera vibrios are ingested in drink or food and the dosage is little. After passing the acidity of the stomach, the organisms start to multiply in the alkaline atmosphere in small intestine. With the aid of enzymes generated by the organisms, they penetrate the mucous layer and adhere to the enterocyte surface.Vibrio Cholerae Enterotoxin:
The main virulence factor in vibrio cholerae is cholera toxin. This is a heat labile enterotoxin with a molecular weight of around 84,000, having sub units A (M.W. 28,000) and B. The sub-unit-B joins on Ganglio side GH1 that serves as the mucosal receptor, and it promotes entry of sub-unit A into the cell. The A sub-unit gives the toxigenic activity intracellularly after proteolytic cleavage into 2 peptides A1 and A2. A1 is the active part of the molecule.
Activation of A1 sub unit raises the levels of intracellular c AMP and outcomes in prolonged hyper secretion of water and electrolytes. There is raised sodium-dependent chloride secretion and sodium and chloride absorption is inhibited. As an outcome diarrhoea takes place, with 20-30 litres per day loss of water.
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