How do the rotavirus NSP4 and bacterial enterotoxins lead differently to diarrhea?

Table 1 Major characteristics of diarrheal diseases associated with bacterial and NSP4 viral enterotoxins.

	Bacterial enterotoxins: *Vibrio cholerae and Escherichia coli*	Viral enterotoxin: NSP4 produced by rotavirus
Morphological damage	No	No
D-glucose absorption via SGLT1	Unimpaired	Impaired
Cl^- absorption at the villus cell level	Decreased	Increased
Cl^- secretion at the crypt cell level	Increased	Unaffected
Net Cl^- secretion	Massive	Moderate
Intracellular mediators of chloride secretion	Cyclic nucleotides (cAMP or cGMP)	Ca²⁺

Bacterial enterotoxins such as cholera toxin and the heat-labile and heat-stable enterotoxins of Escherichia coli are known to cause "pure" secretory diarrhea [36]. The NSP4 viral enterotoxin produced by rotavirus appears to function quite differently from bacterial enterotoxins, aside from the fact that neither type causes morphological damage. Further details in the text.

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