Review on pathogenicity mechanism of enterotoxigenic Escherichia coli and vaccines against it

Enterotoxigenic Escherichia coli (ETEC) is the most common cause of diarrhea in children. Colonization factors (CFs) and LT enterotoxin are the major ETEC candidate vaccines. To cause disease, ETEC must adhere to the epithelium of the small intestine by means of CFs. Watery diarrhea is produced due to the effects of the enterotoxins. Vaccine development against ETEC has been identified as an important primary prevention strategy in developing countries and for travelers to these regions. Mucosal immunization can cause secretory IgA antibody (sIgA) responses that prevents the attachment of bacteria to the intestine and are of particular importance for provide protection against ETEC infection. The design of multivalent ETEC vaccine containing various colonization factors and ETEC toxin may provide protection against a wide range of bacterial strains. In this review, the importance and pathogenesis of ETEC, and the latest ETEC vaccine research results are discussed.