Vibrio cholerae O1 causes dehydrating
diarrhea with a high mortality rate if untreated. The
infection also elicits long-term protective immunity. Since V. cholerae is noninvasive, mucosal immunity is likely important for protection. In this study, we compared humoral immune responses in the duodenal mucosa and blood of
cholera patients at different time points after the onset of disease and compared them with those of healthy controls (HCs). Immune responses to
lipopolysaccharide (LPS) and the recombinant
cholera toxin B subunit (rCTB) were assessed by
enzyme-linked
immunosorbent assay (ELISA) and
enzyme-linked immunospot (ELISPOT) assay. Significant increases in V. cholerae LPS-specific
IgA and
IgG antibody levels were seen in duodenal extracts on day 30, but the levels decreased to baseline by day 180; plasma V. cholerae LPS-specific
IgA levels remained elevated longer. Levels of mucosal CTB
antibodies also peaked on day 30, but the increase reached statistical significance only for
IgG. A significant correlation was found between the CTB antibody-secreting cell (ASC) response in the circulatory system on day 7 and subsequent CTB-specific
IgA levels in duodenal extracts on day 30 and the numbers of CTB-specific
IgA ASCs in duodenal tissues on day 180. The proportion (0.07%) of mucosal V. cholerae LPS
IgA ASCs peaked on day 30 and remained elevated through day 180 compared to that of HCs (P = 0.03). These results suggest that protective immunity against V. cholerae is not likely mediated by the constitutive secretion of
antibodies at the mucosal surface; our results are consistent with those of other studies that suggest instead that anamnestic immune responses of mucosal lymphocytes may play a major role in protection against
cholera.