Escherichia coli heat-stable enterotoxin: biochemical and physiological effects on the intestine.

E. coli which elaborate suckling mouse active small MW heat-stable enterotoxin (STa), are important causes of diarrhea in animals and man. These STa's share the property of causing intestinal secretion and diarrhea by virtue of inhibiting the absorption of sodium and chloride and possibly stimulating the secretion of chloride. STa's seem to act in the colon as well as the small intestine and the alterations in intestinal ion and water transport are probably mediated by the guanylate cyclase-cyclic GMP system. Glucose transport is unaffected. STa also causes alterations in the myoelectrical activity of the small intestine which may result in the loss of normal peristaltic activity. STa binds in a reversible fashion to specific receptors on the surface of small intestinal and colonic epithelial cells. The mechanisms whereby occupation of the STa receptors lead to activation of the guanylate cyclase system and intestinal secretion are unknown but may involve influx of calcium through calcium channels, stimulation of prostaglandin synthesis and release of free radicals.