Vasoactive intestinal peptide (VIP) in the pathogenesis of cholera – a descriptive study

Background

Cholera is a rapidly dehydrating diarrheal illness and remains a global threat to public health. Recently it has been estimated that there are approximately 2.8 million cholera cases and 91,500 cholera deaths in cholera-endemic countries. Till date, no medication exists which can quickly curtail cholera diarrhea.

Knowledge gap

Currently, there have not been studies to understand whether vasoactive intestinal polypeptide (VIP) is a mediator in the pathogenesis of cholera.

Relevance

If VIP is a mediator for cholera diarrhoea, VIP antagonists/blockers could significantly curtail cholera diarrhea. Hopefully this might reduce cholera related morbidity & mortality in endemic countries.

Objectives

To determine VIP levels in cholera ricewater stool and in patients’ plasma obtained simultaneously, both before and after correction of severe dehydration using standard intravenous rehydration and maintenance therapy. Thus to confirm a role of VIP in cholera pathophysiology.

Methods

This would be a descriptive study, patients of either sex, aged 18-64 years attending the Dhaka Hospital of icddr,b with severe dehydration due to cholera will comprise the study population. Rectal catheter stool & venous blood specimen will be obtained just before initiation of IV rehydration therapy, after post rehydration, 24 hours after post rehydration & before discharge.

Outcome measures/variables

Primary outcome measure will be stool & plasma VIP level before & after correction of severe dehydration
Secondary outcome measures will be time to cessation of diarrhoea, the total volume of stool output (ml/kg/hr), the total volume of IVF received, and the total volume of ORS received, development of any severe complications, as decided by treating physician.

Cholera is diarrheal illness and can cause severe dehydration rapidly. Cholera remains a global threat to public health. Recently it has been estimated that there are approximately 2.8 million cholera cases and 91,500 cholera deaths in cholera-endemic countries. Till date, no medication exists which can quickly curtail cholera diarrhea. Currently, there have not been studies to understand whether Vasoactive intestinal peptide (VIP) is a mediator in the pathogenesis of cholera. If VIP is a mediator for cholera diarrhoea, VIP antagonists/blockers could significantly curtail cholera diarrhea. Hopefully this might reduce cholera related morbidity & mortality in endemic countries.

If VIP is a mediator for cholera diarrhoea, VIP antagonists/blockers could significantly curtail cholera diarrhea. Hopefully this might reduce cholera related morbidity & mortality in endemic countries.