Involvement of cell envelope components in the pathogenesis of Vibrio cholerae: targets for cholera vaccine development.

Parenteral cholera vaccines have for some years been removed from the WHO recommendations. With a greater understanding of the immunology of gut infections has come the realization that oral vaccines are the most promising approach. There are several possible approaches: killed vaccines, attenuated Vibrio cholerae and true recombinants in which V. cholerae protective antigens are introduced into suitable carrier strains. This latter approach has perhaps greater potential as a carrier strain can be chosen/developed which most effectively stimulates the local immune response in the gut. This necessitates the identification of the important protective antigens. These antigens are thought to be components of the cell envelope which are involved in adhesion and colonization.