How can we battle the scourge of diarrhea? 2003 McKenna Memorial Lecture
diseases exact a considerable toll of morbidity and
mortality worldwide, including in developed countries
where the incidence of foodborne illness, in particular,
may be increasing. This article summarizes the current
understanding of the basis of diarrheal illness, focusing
particularly on intracellular signaling mechanisms that
limit the extent of intestinal epithelial chloride secretion,
which may offer new targets for antidiarrheal therapies.
Recent information regarding the mechanisms whereby
invasive bacteria cause diarrhea is also reviewed along
with effects of beneficial bacteria (so-called probiotics)
in limiting dysfunction associated with enteric infections.
Finally, the author provides some speculations as to
the possible benefits to the host of mounting a diarrheal
response to an offending pathogen, and possible consequences
of the failure of this primitive host defense mechanism.