What does the cholera do directly to the intracellular processes (be specific)?

Question

What does the cholera do directly to the intracellular processes (be specific)?
The two circles next to fluid absorption and fluid secretion need either (+ or -) depending on how you think cholera effects fluid in the intestine (put a + or - in the circles on the picture).
What is the most reasonable major symptom a patient with cholera would be suffering from and ultimately what causes them to die (use the diagram to explain)? Basolateral Apical H20 Nat Vibrio cholerae H2O ATP Fluid 3Na* 2K+ bsorption ADP ER Fluid Secretion 2Nat ATP Glucose PKA CAMP Glucose-_ CI H20 " > H20 SGLT1 Cholera toxin (CT) NHE3 GM1 O OGLUT2 -CFTR Adenylyl cyclaseA1 chain CT Na /K-ATPase

Explanation / Answer

Cholea occurs due to infection with vibrio cholerae. Vibrio cholerae produces a toxin which increases the net production of cAMP within a cell. The increased cAMP then carries on the downstream effects. cAMP blocks the absorption of sodium and chloride by the microvilli and promotes the secretion of chloride and water by the crypt cells. This results in severe diarrhoea because of less absorption of fluid from intestine and secretion of more fluid into the intestine.

Fluid absorption from intestine decreases and thus the circle will be negative (-). Fluid secretion into the intestine increases and thus the circle will be positive (+)

The most reasonable symptoms of cholera is dehydration. Here in diagram, it is clear that severe water loss (dehydration) occurs apically or basolaterally in case of cholera. Severe loss of water causes severe fall in blood pressure, increase in heart rate, confusion, comma and ultimately death occurs.

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