Enterotoxin-Specific Immunoglobulin E Responses in Humans after Infection or Vaccination with Diarrhea-Causing Enteropathogens

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Abstract
Cholera toxin (CT)-specific antibody responses of the immunoglobulin E (IgE) isotype in the sera of adult patients suffering from infection with eitherVibrio choleraeO1,V. choleraeO139, or enterotoxigenicEscherichia coli(ETEC) were analyzed and compared with those in the sera of volunteers immunized with a bivalent B subunit O1/O139 whole-cell cholera vaccine. A significant IgE response to CT was observed in 90% of the patients withV. choleraeO1 infection (18 of 20;P= V. choleraeO139 infection (19 of 20;P= V. choleraeO1 showed CT-specific IgE responses (P= 0.004). In contrast, Swedish volunteers immunized with the oral cholera vaccine showed no IgE responses to CT (Pvalue not significant). During the study period, total IgE levels in the sera of the diarrheal patients, the North American volunteers, and the Swedish cholera vaccinees alike remained unchanged. However, the total IgE levels in the sera of patients and healthy Bangladeshi controls were on average 89-fold higher than those in the sera of the healthy Swedish volunteers and 34-fold higher than those in the sera of the North American volunteers.