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Cholera and Pancreatic Cholera: Is VIP the Common Pathophysiologic Factor?
Farzana Afroze1, Steven Bloom2, Paul Bech2
1International Centre for Diarrheal Disease Research (icddr,b), Dhaka 1212, Bangladesh.
Tropical Medicine and Infectious Disease
|July 8, 2020
Summary
Vasoactive intestinal polypeptide (VIP) in stool, but not plasma, was significantly elevated in cholera patients. High stool VIP levels correlated with increased stool output and longer hospital stays, suggesting VIP plays a role in cholera severity.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Molecular Medicine
Background:
- Cholera is a severe diarrheal disease causing dehydration and shock, particularly in developing nations.
- Vasoactive intestinal polypeptide (VIP) is known to mediate pancreatic cholera syndrome.
- The role of VIP in the pathophysiology of human cholera requires further investigation.
Purpose of the Study:
- To investigate the role of vasoactive intestinal polypeptide (VIP) in the pathophysiology of human cholera.
- To measure plasma and stool VIP levels in cholera patients and correlate them with clinical outcomes.
Main Methods:
- A prospective observational study was conducted on 23 cholera patients hospitalized with severe dehydration.
- Plasma and stool VIP levels were measured at multiple time points: admission, post-rehydration, and discharge.
- Multivariable Generalized Estimating Equation (GEE) models were used for statistical analysis.
Main Results:
- Stool VIP (sVIP) levels were significantly elevated in cholera patients compared to plasma VIP (pVIP) levels, which remained within the normal range.
- Elevated sVIP levels were consistently observed across all measured time points.
- Multivariable analysis revealed a significant association between higher sVIP levels and increased duration of hospitalization, total stool volume, and 24-hour stool output.
Conclusions:
- The findings suggest that VIP, released by intestinal nerves, plays a significant role in human cholera.
- Elevated stool VIP levels are linked to increased disease severity and duration.
- Inhibitors targeting intestinal VIP warrant investigation as potential therapeutic agents for cholera.
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