The induction of interleukin-8 (IL-8) in vitro has been suggested to correlate with the reactogenicity of Vibrio cholerae vaccine candidates. V. cholerae vaccine candidate 638, a hemagglutinin protease/hap-defective strain, was recently reported to be well tolerated in human volunteers, suggesting a role for Hap in reactogenicity. We examined the role of hap in the induction of IL-8 in intestinal epithelial T84 cells. Wild-type V. cholerae strains 3038 and C7258 and a vaccine candidate strain, JBK70, induced levels of IL-8 similar to those of their isogenic hap mutants. Supernatant containing Hap did not stimulate IL-8 production at a variety of concentrations tested, suggesting that Hap itself does not induce IL-8 production. Furthermore, supernatant from CVD115, which had deletions of hap and rtxA (encoding repeats in toxin) and was derived from a reactogenic strain, CVD110, induced IL-8 production in T84 cells in a dose-dependent manner. The IL-8-stimulating activity of CVD115 culture supernatants was growth phase dependent and was strongest in stationary phase cultures. This IL-8 stimulator(s) was resistant to heat treatment but sensitive to proteinase. Protease activity in vitro did not correlate with the reactogenicity of V. cholerae vaccine candidates. Our data suggest that Hap is not an IL-8 inducer in T84 cells and that the IL-8 stimulator in the supernatant of V. cholerae culture may play a role in reactogenicity.The acute diarrheal disease cholera remains a significant public health problem, causing more than five million cases and 200,000 deaths annually in the world (47). Vibrio cholerae, the etiologic agent of cholera, is transmitted by contaminated water and food. It colonizes the surface of the small intestine, where it secretes cholera toxin (CT), which is largely responsible for the acute diarrhea characteristic of cholera. Although there are more than 200 O-antigen serogroups of V. cholerae, only the O1 and O139 serogroups are associated with epidemic cholera (22). The O1 serogroup can be divided further into two biotypes, classical and El Tor, based on various biochemical and phenotypic differences (for a review, see reference 22). One important difference in particular is that V. cholerae strains of the classical biotype do not have rtx genes, encoding repeats in toxin (27), and the majority of classical strains do not produce hemagglutinin/protease (Hap) or hemolysin (22). Several groups of investigators have constructed a variety of live attenuated V. cholerae O1 and O139 vaccine candidates by deleting the ctx genes encoding cholera toxin (21,26,30,46,48). However, in clinical trials most V. cholerae vaccine candidates still exhibit reactogenicity, which includes mild diarrhea, malaise, nausea, vomiting, abdominal cramps, low-grade fever, and headache (8,21,45,46,48). The only licensed oral live cholera vaccine, CVD103-HgR, is well tolerated and highly protective in North American volunteers (26, 43, 46); however, it was poorly protective in a field trial involving 67,500 people in Indones...