Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC

Enterotoxigenic <i>Escherichia coli</i> (ETEC) is a major cause of diarrheal disease worldwide, particularly in children in low- and middle-income countries. Its ability to rapidly colonize the intestinal tract through diverse colonization factors and toxins underpins its significant pub...

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Main Authors: Josune Salvador-Erro, Yadira Pastor, Carlos Gamazo
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Toxins
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Online Access:https://www.mdpi.com/2072-6651/17/2/71
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author Josune Salvador-Erro
Yadira Pastor
Carlos Gamazo
author_facet Josune Salvador-Erro
Yadira Pastor
Carlos Gamazo
author_sort Josune Salvador-Erro
collection DOAJ
description Enterotoxigenic <i>Escherichia coli</i> (ETEC) is a major cause of diarrheal disease worldwide, particularly in children in low- and middle-income countries. Its ability to rapidly colonize the intestinal tract through diverse colonization factors and toxins underpins its significant public health impact. Despite extensive research and several vaccine candidates reaching clinical trials, no licensed vaccine exists for ETEC. This review explores the temporal and spatial coordination of ETEC virulence factors, focusing on the interplay between adherence mechanisms and toxin production as critical targets for therapeutic intervention. Advancements in molecular biology and host–pathogen interaction studies have uncovered species-specific variations and cross-reactivity between human and animal strains. In particular, the heat-labile (LT) and heat-stable (ST) toxins have provided crucial insights into molecular mechanisms and intestinal disruption. Additional exotoxins, such as EAST-1 and hemolysins, further highlight the multifactorial nature of ETEC pathogenicity. Innovative vaccine strategies, including multiepitope fusion antigens (MEFAs), mRNA-based approaches, and glycoconjugates, aim to enhance broad-spectrum immunity. Novel delivery methods, like intradermal immunization, show promise in eliciting robust immune responses. Successful vaccination against ETEC will offer an effective and affordable solution with the potential to greatly reduce mortality and prevent stunting, representing a highly impactful and cost-efficient solution to a critical global health challenge.
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spelling doaj-art-cd8b375784f645e29f46d5ca962cadfa2025-08-20T02:45:38ZengMDPI AGToxins2072-66512025-02-011727110.3390/toxins17020071Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETECJosune Salvador-Erro0Yadira Pastor1Carlos Gamazo2Department of Microbiology and Parasitology, Navarra Medical Research Institute (IdiSNA), University of Navarra, 31008 Pamplona, SpainDepartment of Microbiology and Parasitology, Navarra Medical Research Institute (IdiSNA), University of Navarra, 31008 Pamplona, SpainDepartment of Microbiology and Parasitology, Navarra Medical Research Institute (IdiSNA), University of Navarra, 31008 Pamplona, SpainEnterotoxigenic <i>Escherichia coli</i> (ETEC) is a major cause of diarrheal disease worldwide, particularly in children in low- and middle-income countries. Its ability to rapidly colonize the intestinal tract through diverse colonization factors and toxins underpins its significant public health impact. Despite extensive research and several vaccine candidates reaching clinical trials, no licensed vaccine exists for ETEC. This review explores the temporal and spatial coordination of ETEC virulence factors, focusing on the interplay between adherence mechanisms and toxin production as critical targets for therapeutic intervention. Advancements in molecular biology and host–pathogen interaction studies have uncovered species-specific variations and cross-reactivity between human and animal strains. In particular, the heat-labile (LT) and heat-stable (ST) toxins have provided crucial insights into molecular mechanisms and intestinal disruption. Additional exotoxins, such as EAST-1 and hemolysins, further highlight the multifactorial nature of ETEC pathogenicity. Innovative vaccine strategies, including multiepitope fusion antigens (MEFAs), mRNA-based approaches, and glycoconjugates, aim to enhance broad-spectrum immunity. Novel delivery methods, like intradermal immunization, show promise in eliciting robust immune responses. Successful vaccination against ETEC will offer an effective and affordable solution with the potential to greatly reduce mortality and prevent stunting, representing a highly impactful and cost-efficient solution to a critical global health challenge.https://www.mdpi.com/2072-6651/17/2/71adjuvantenterotoxigenic <i>Escherichia coli</i> (ETEC)toxinsvaccine developmentvirulence factors
spellingShingle Josune Salvador-Erro
Yadira Pastor
Carlos Gamazo
Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC
Toxins
adjuvant
enterotoxigenic <i>Escherichia coli</i> (ETEC)
toxins
vaccine development
virulence factors
title Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC
title_full Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC
title_fullStr Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC
title_full_unstemmed Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC
title_short Targeting Enterotoxins: Advancing Vaccine Development for Enterotoxigenic <i>Escherichia coli</i> ETEC
title_sort targeting enterotoxins advancing vaccine development for enterotoxigenic i escherichia coli i etec
topic adjuvant
enterotoxigenic <i>Escherichia coli</i> (ETEC)
toxins
vaccine development
virulence factors
url https://www.mdpi.com/2072-6651/17/2/71
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