A comprehensive review of therapeutic approaches available for the treatment of cholera

J Pharm Pharmacol. 2020 Dec;72(12):1715-1731. doi: 10.1111/jphp.13344. Epub 2020 Jul 31.

Abstract

Objectives: The oral rehydration solution is the most efficient method to treat cholera; however, it does not interfere in the action mechanism of the main virulence factor produced by Vibrio cholerae, the cholera toxin (CT), and this disease still stands out as a problem for human health worldwide. This review aimed to describe therapeutic alternatives available in the literature, especially those related to the search for molecules acting upon the physiopathology of cholera.

Key findings: New molecules have offered a protection effect against diarrhoea induced by CT or even by infection from V. cholerae. The receptor regulator cystic fibrosis channel transmembrane (CFTR), monosialoganglioside (GM1), enkephalinase, AMP-activated protein kinase (AMPK), inhibitors of expression of virulence factors and activators of ADP-ribosylarginine hydrolase are the main therapeutic targets studied. Many of these molecules or extracts still present unclear action mechanisms.

Conclusions: Knowing therapeutic alternatives and their molecular mechanisms for the treatment of cholera could guide us to develop a new drug that could be used in combination with the rehydration solution.

Keywords: cholera; cholera toxin; molecular mechanism.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Cholera / diagnosis
  • Cholera / drug therapy*
  • Cholera / microbiology
  • Cholera Toxin / metabolism
  • Combined Modality Therapy
  • Fluid Therapy
  • Host-Pathogen Interactions
  • Humans
  • Molecular Targeted Therapy
  • Rehydration Solutions / therapeutic use
  • Treatment Outcome
  • Vibrio cholerae / drug effects*
  • Vibrio cholerae / metabolism
  • Vibrio cholerae / pathogenicity
  • Virulence Factors / metabolism

Substances

  • Anti-Bacterial Agents
  • Rehydration Solutions
  • Virulence Factors
  • Cholera Toxin