Mechanisms of the evolutionary arms race between Vibrio cholerae and Vibriophage clinical isolates.

This review highlights recent findings on the evolutionary arms race between the causative agent of cholera Vibrio cholerae and virulent bacteriophages (phages) ICP1, ICP2, and ICP3 isolated from cholera patient stool samples. We discuss mechanisms of phage resistance such as a unique phage-inhibitory chromosomal island and mutations that affect phage receptor expression. We also discuss the molecular characterization of ICP1 and its unique CRISPR-Cas system, which it uses to combat the phage-inhibitory chromosomal island. The role of phages in the life cycle of V. cholerae has been increasingly recognized and investigated in the past decade. This article will review hypotheses as to how the predator-prey relationship may have an impact on infections within individuals and on the self-limiting nature of cholera epidemics. In addition, we put forth a strategy of using phages as an intervention to reduce household transmission of cholera within a community.