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Vaccines against enterotoxigenic Escherichia coli.

Journal article
Authors Ann-Mari Svennerholm
Joshua Tobias
Published in Expert review of vaccines
Volume 7
Issue 6
Pages 795-804
ISSN 1744-8395
Publication year 2008
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Pages 795-804
Language en
Keywords Child, Preschool, Diarrhea, prevention & control, Enterotoxigenic Escherichia coli, immunology, Escherichia coli Infections, epidemiology, prevention & control, Escherichia coli Vaccines, immunology, Humans, Infant, Infant, Newborn, Travel
Subject categories Microbiology in the medical area


Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrhea among children less than 3 years of age in developing countries and in travelers to these areas. The key pathogenic mechanisms that contribute to the pathogenesis of ETEC are the production of colonization factors (CFs) and a heat-labile enterotoxin (LT) and/or a heat-stable enterotoxin. To provide broad-spectrum protection, an ETEC vaccine should, most likely, contain the most prevalent fimbrial antigens, that is, CF antigen I and CS1-CS6, and/or a LT toxoid. Different strategies have been taken to deliver ETEC fimbriae and toxin antigens to the human immune system to elicit strong mucosal, in particular, intestinal immune responses that are considered to be of prime importance for protection against ETEC disease. There has been some promise when testing different ETEC candidate vaccines for protection against diarrhea in adult travelers. However, no ETEC candidate vaccine has been shown to be effective in the most important target group, which is infants and young children in endemic areas. Against this background, intense efforts are in progress to try to improve the immunogenicity of different available candidate vaccines, as well as to develop new types of ETEC vaccines.

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