Vibrio cholerae O1 is a major cause of acute watery
diarrhea in over 50 countries. Evidence suggests that V. cholerae O1 may activate inflammatory pathways, and a recent study of a Bangladeshi population showed that variants in innate immune genes play a role in mediating susceptibility to
cholera. We analyzed human
proteins present in the small intestine of patients infected with V. cholerae O1 to characterize the host response to this pathogen. We collected duodenal biopsy specimens from patients with acute
cholera after stabilization and again 30 days after initial presentation.
Peptides extracted from biopsy specimens were sequenced and quantified using label-free mass spectrometry and SEQUEST. Twenty-seven host
proteins were differentially abundant between the acute and convalescent stages of
infection; the majority of these have known roles in innate defense,
cytokine production, and apoptosis. Immunostaining confirmed that two
proteins, WARS and S100A8, were more abundant in lamina propria cells during the acute stage of
cholera. Analysis of the differentially abundant
proteins revealed the activation of key regulators of
inflammation by the innate immune system, including
Toll-like receptor 4, nuclear factor kappa-light-chain-enhancer of activated B cells,
mitogen-activated protein kinases, and
caspase-dependent
inflammasomes. Interleukin-12β (IL-12β) was a regulator of several
proteins that were activated during
cholera, and we confirmed that IL-12β was produced by lymphocytes recovered from duodenal biopsy specimens of
cholera patients. Our study shows that a broad inflammatory response is generated in the gut early after onset of
cholera, which may be critical in the development of long-term mucosal immunity against V. cholerae O1.