Enterotoxigenic diarrhea: mechanisms and prospects for therapy.

Studies over the past decade have led to a rudimentary but working knowledge of intestinal electrolyte transport. Purification of bacterial exotoxins has allowed an understanding of how these agents stimulate cells. Coupled NaCl influx processes and chloride secretory mechanisms have been shown to be affected by exotoxin-stimulated increases in cyclic nucleotides, as well as by increases in intracellular calcium and arachidonic acid metabolites. Catecholamines, somatostatin, phenothiazines, nonsteroidal anti-inflammatory drugs, and opiates appear to be the most promising of the antisecretory drugs. While the mechanism of action of these agents remains to be determined, there is significant hope that effective antisecretory drugs will emerge in the near future.