These data were further supported by a study of gene expression in duodenal biopsy specimens from cholera patients from whom acute- and convalescent-phase samples were compared; NF-κB signaling was found to be the most upregulated pathway in acute disease (17), and IL-1β, IL-6, and IL-23 were identified as top upstream regulators during acute infection (16, 17). This evidence concerns the gene IL6 and vibrio infectious disease.