Immunological interrelationships between cholera toxin and the heat-labile and heat-stable enterotoxins of coliform bacteria

Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors

Bacteria belonging to the genus Klebsiella frequently cause human nosocomial infections. In particular, the medically most important Klebsiella species, Klebsiella pneumoniae, accounts for a significant proportion of hospital-acquired urinary tract infections, pneumonia, septicemias, and soft tissue infections. The principal pathogenic reservoirs for transmission of Klebsiella are the gastrointestinal tract and the hands of hospital personnel. Because of their ability to spread rapidly in the hospital environment, these bacteria tend to cause nosocomial outbreaks. Hospital outbreaks of multidrug-resistant Klebsiella spp., especially those in neonatal wards, are often caused by new types of strains, the so-called extended-spectrum-beta-lactamase (ESBL) producers. The incidence of ESBL-producing strains among clinical Klebsiella isolates has been steadily increasing over the past years. The resulting limitations on the therapeutic options demand new measures for the management of Klebsiella hospital infections. While the different typing methods are useful epidemiological tools for infection control, recent findings about Klebsiella virulence factors have provided new insights into the pathogenic strategies of these bacteria. Klebsiella pathogenicity factors such as capsules or lipopolysaccharides are presently considered to be promising candidates for vaccination efforts that may serve as immunological infection control measures.

Occurrence of virulence-associated properties in Enterobacter cloacae

Enterobacter cloacae is not a primary human pathogen but has been considered to be an important cause of nosocomial infections. Even so, there are almost no reports on its ability to produce recognized virulence-associated properties. In this study, we show that most of the E. cloacae strains examined were resistant to serum bactericidal activity and were able to produce aerobactin and mannose-sensitive hemagglutinin, and all of them could adhere to and invade HEp-2 cells. Since E. cloacae is part of the normal intestinal floras of many individuals, we believe that infectious disease due to endogenous E. cloacae might be a result of both host predisposing factors and the bacterial virulence determinants that we have detected in this survey.

Cytotoxic component(s) of Klebsiella oxytoca on HEp-2 cells

A cytotoxic component(s) was detected in culture filtrates of Klebsiella oxytoca isolated from patients with antibiotic-associated hemorrhagic colitis. Eleven of 12 isolates exhibited cytotoxicity on HEp-2 cells. The cytotoxic activity of K. oxytoca strain MH43-1 was stable for the treatment of 60 C for 30 min, but inactivated by the treatment of 100 C for 15 min. This cytotoxicity was not destroyed by the treatment with trypsin or pronase, and the component was filtrable through a membrane filter which cut off molecular weight 5,000.

Protection of rats against cholera toxin and cholera-like enterotoxins by immunization with enteric-coated cholera toxin

Pure cholera toxin (CT) given as a booster in enteric-coated tablets to rats produced a humoral and intestinal immune response similar to the result of instilling the boosting dose of CT directly into the duodenum. This method protects the antigen against gastric acid and allows delivery of the immunogen to intestinal mucosa, an essential step in producing intestinal secretory IgA. Immunization gave protection against pure CT during intestinal perfusion but also significantly protected against the secretory effects of E. coli LT and CT-like toxin of A. sobria. The use of enteric-coated vaccines offers advantages for mass immunization programmes and our results suggest that immunization with preparations containing CT holotoxin may protect against heterologous toxins which cross-react with CT.

Immunological relationships between cholera toxin and Escherichia coli heat-labile enterotoxin

The antigenic relationships between heat-labile enterotoxin (LT) produced by a human strain of enterotoxigenic Escherichia coli (strain 286C2) and cholera toxin (CT) were examined by using antisera raised against LT and CT and specific antisera prepared against each subunit of both enterotoxins. Double immunodiffusion analysis revealed reactions of partial identity between the A subunits of LT and CT, as well as between the B subunits. Rabbit antisera raised against LT subunit A reacted with only subunit A, whereas rabbits immunized with LT subunit B produced antibodies which reacted with only subunit B. A high degree of CT neutralization was observed with antisera raised against LT. Data from neutralization assays with specific antisera to each enterotoxin showed that LT was more effectively neutralized by homologous anti-LT than CT (3.7-fold); however, anti-CT was only slightly more effective in neutralization of homologous CT compared with LT (1.9-fold). In contrast, antisera raised against the B subunit of CT (choleragenoid) exhibited significantly higher neutralization activity against CT than LT (5.8-fold); however, the amount of CT neutralized by anticholeragenoid was less (4.1-fold) than anti-CT. These results suggested that anti-CT serum contained neutralizing antibodies reactive with a shared determinant formed by interaction of the A and B subunits, whereas anti-LT and anti-choleragenoid sera did not. Sensitive solid-phase radioimmunoassays were developed to examine the affinity and degree of specificity involved in homologous and heterologous antigen-antibody interactions between LT, CT, their subunits, and specific antibodies. Only unlabeled LT competed with radiolabeled LT in polystyrene tubes coated with anti-LT, and only unlabeled CT competed with radiolabeled CT in tubes coated with anti-CT. However, when radiolabeled CT was incubated in tubes coated with anti-LT, competitive inhibition responses were observed with both unlabeled toxins. When radiolabeled LT was incubated with tubes coated with anti-CT, competitive inhibition responses were observed with both unlabeled toxins. Similar competitive inhibition responses were observed with the A subunits of LT and CT and with the B subunits using antisera specific for the subunits of each enterotoxin. Double immunodiffusion analysis and radioimmunoassay data supported the presence of unique and shared immunodeterminants in each subunit.

Synthesis of plasmid-coded heat-labile enterotoxin in wild-type and hypertoxinogenic strains of Escherichia coli and in other genera of Enterobacteriaceae

The effect of host determinants on expression of plasmid-coded heat-labile enterotoxin (LT) was examined. A collection of LT plasmids was introduced into isogenic strains of Escherichia coli K-12 strains containing the wild type or hypertoxinogenic (htx-2) allele. For each plasmid tested, production of LT increased by approximately 1.5- to 3-fold in the host containing htx-2, indicating that the htx-2 allele affects a regulatory function for LT production that is common to many different enterotoxin plasmids. LT plasmids from E. coli were also introduced into strains of Shigella flexneri, Shigella sonnei, Citrobacter freundii, Enterobacter cloacae, Klebsiella pneumoniae, and Salmonella typhimurium. The plasmids were stably maintained and determined production of LT in those genera, although the amounts of LT produced varied by more than 50-fold. These observations demonstrate that host factors have an important role in determining the level of expression of plasmid-coded LT genes and support the hypothesis that interspecific, conjugal transfer of enterotoxin plasmids may confer enterotoxigenicity to a wide variety of potentially pathogenic enteric bacteria.

Mapping of a gene in Vibrio cholerae that determines the antigenic structure of cholera toxin

In Ouchterlony-type immunodiffusion gels, the cholera toxin produced by the classical Vibrio cholerae strain 569B was indistinguishable from the cholera toxin of the Eltor strain RJ1. However, the cholera toxin produced by both of these strains was incompletely cross-reactive with the cholera toxin produced by the Eltor strain 3083-2. The allele of the gene responsible for the 569B and RJ1 type of toxin was designated vct-1, and the allele responsible for the 3083-2 type of toxin was designated vct-2. The vct-1 allele was transferred from RJ1 donors to 3083-2 recipients by conjugation. The vct locus was found to be between met and trp on the V. cholerae linkage map.

Immunological cross-reactivity of enterotoxins of Aeromonas hydrophila and cholera toxin

Pre-incubation with anticholera toxin (ACT) significantly reduced intestinal secretion induced by cell-free broth preparations of heat-labile toxins (LT) of Escherichia coli and Aeromonas hydrophila in jejunal perfusion experiments in rats in vivo. Pre-incubation with ACT also prevented cytotoxicity by E. coli LT in the Y1 cell culture system. Pre-incubation had no effect on cytotoxicity in Y1 and L132 cell lines or on haemolytic activity with cell-free preparations of A. hydrophila. In another series of experiments rats were immunized with cholera toxin given as an intraperitoneal priming dose followed 12 days later by intraduodenal boosting. Immunization significantly protected against net intestinal fluid secretion induced by enterotoxigenic E. coli and A. hydrophila and by cholera toxin.

Identification of low levels of heat labile enterotoxin in Escherichia coli from children with diarrhoea

Out of 40 children with gastroenteritis and massive growth of E. coli in faeces, 7 yielded growth of E. coli strains producing heat-labile enterotoxin (LT), as identified by enzyme-linked immunosorbent assay (ELISA) using anticholera toxin coated plates or ganglioside coated plates. The toxin production in vitro was low, and decreased upon subculturing for 3 months in the laboratory. Only two of the strains were identified as LT-positive by the YI adrenal cell test. In addition, an LT-producing strain was isolated from an adult who had recently returned from Jordan. Sonication of the strains after subculturing released cell-bound LT. The clinical importance of such low toxin producing E. coli strains is not known.

Enterotoxigenic bacteria in food and water from an Ethiopian community

Food and water samples from an Ethiopian community were screened for the presence of enterotoxin-producing bacteria. Using the Chinese hamster ovary cell assay, 40 of 213 isolates (18.8%) produced heat-labile (LT) enterotoxin. These LT-producing isolates comprised 33 of 177 (18.6%) strains from 24 of 68 food samples (35.3%) and 7 of 36 (19.4%) isolates of 4 of 17 water samples (23.5%). One LT-producing strain each of Salmonella emek and of Shigella dysenteriae was found. Three pseudomonads, all LT producers, produced heat-stable enterotoxin as gauged by the suckling mouse test. Two strains of LT-enterotoxigenic Escherichia coli O68 were found in water samples. No enterotoxigenic E. coli were isolated from food samples, but 13 of the LT-producing strains were Enterobacter, Klebsiella, Serratia, and Proteus species, and 7 food samples yielded more than one species of enterotoxigenic bacterium. Of the enterotoxigenic isolates from food, 15 were oxidase-positive strains of the genera Aeromonas, Pseudomonas, Achromobacter, Flavobacterium, and Vibrio. LT-enterotoxigenic Enterobacter, Acinetobacter, Klebsiella, Proteus, Providencia, and Serratia species represented 20 of the food and water isolates. Culture supernatant fluids of representative strains of oxidase-positive and oxidase-negative species giving positive reactions in Chinese hamster ovary cell tests induced fluid accumulation in rabbit ileal loops. Eight of the food samples and two of the water samples contained more than one isolate or species of enterotoxigenic bacterium. The stability of the LT production by oxidase-positive bacteria and non-E. coli strains was assessed by the rabbit skin and adrenal cell tests after 9 months and 1 year of storage, respectively, in Trypticase soy broth with glycerol at -70 degrees C. Only 33% of the oxidase-positive strains were still LT enterotoxigenic. Of the oxidase-negative strains, 50 and 33% were LT producing at 9 months and 1 year, respectively. None of the E. coli isolates, both enterotoxigenic and nonenterotoxigenic, possessed K88, K99, or colonization factor antigen. The survey demonstrates the presence in food and water of enterotoxigenic bacteria of the same species as those isolated from cases of infantile diarrhea in the same community, although a correlation between these sources and infantile diarrhea remains to be established.

Respective contributions to protection of primary and booster immunization with Escherichia coli heat-labile enterotoxin in rats

The respective contributions to protection of the route and dosage of primary and booster immunizations with Escherichia coli heat-labile enterotoxin were evaluated in rats. The degree of protection was determined by challenge with toxin and viable bacteria in ligated ileal loops, and the serum antitoxin response was assayed by enzyme-linked immunosorbent assay. Primary immunization was effective only when given by the parenteral route. The degree of protection was enhanced a fivefold dosage increase in the primary parenteral immunization in rats given constant dosages of booster immunizations either parenterally or perorally, but not by further dosage increases. In contrast, the degree of protection rose when dosages of the booster immunizations were increased over a 25-fold range. Four weekly peroral, but only two biweekly parenteral, booster immunizations were necessary to achieve strong protection; biweekly combined parenteral and peroral booster immunizations yielded both strong, immediate and extended protection. The degree of protection against the toxin correlated with that against viable bacteria and with elevated serum antitoxin titers: all seven groups with a protection index of greater than 5 against the toxin had strong protection against heat-labile toxin-producing strains and fourfold or greater increases in the antitoxin titers, whereas none of the nine groups with a protection index of less than 3 was protected against bacteria or had an equivalent antitoxin response. These observations show that once an adequate parenteral primary immunization is given, the degree of protection is influenced primarily by the dosage of the booster immunizations, the necessary number of which is dependent on their route of administration.

Immunological cross-reactivity of heat-labile enterotoxins produced by enterotoxigenic and enteropathogenic strains of Escherichia coli

Weanling rats were immunized with a heat-labile enterotoxin contained in whole cell lysate (WCL) ultrafiltrate preparations of enteropathogenic (EPEC) and enterotoxigenic (ETEC) strains or with a purified preparation of heat-labile toxin (LT) from the ETEC strain and then challenged either with viable bacteria of each strain or the purified ETEC LT by means of the ileal ligated loop technique. Immunization with the WCL toxin preparations of either the EPEC or ETEC strain conferred protection against challenge with viable organisms of both strains; immunization with a similar preparation from a nontoxigenic strain did not yield protection. Immunization with either the WCL or purified LT toxin from ETEC strain afforded protection against challenge with the ETEC LT toxin, but immunization with the EPEC WCL preparation did not. The antigenicity of all of the toxin preparations was destroyed by heat-treatment. Possible contributory protective effects of somatic or colonization factor (CFA) antigens present in the WCL were excluded by the findings that protection was afforded against a heterologous somatic serotype, ileal bacterial counts were not reduced in protected animals, and WCL preparations of strains containing or lacking CFA yielded equal protection. These observations indicate that the heat-labile enterotoxin of EPEC strains is antigenic and is immunologically related to a heat-labile toxin present in similarly prepared material from an ETEC strain but not to the conventional LT toxin of ETEC strains. They suggest that the WCL preparation of the ETEC strain contains two heat-labile enterotoxins, one of which is conventional LT and the other of which resembles the EPEC toxin.

Protective effect of immunization with heat-labile enterotoxin in gnotobiotic rats monocontaminated with enterotoxigenic Escherichia coli

The protective effect of active immunization with a purified preparation of the polymyxin-release form of Escherichia coli heat-labile enterotoxin (LT), administered using a parenteral prime and peroral boosts given after ablation of gastric secretion by means of cimetidine, was assessed in gnotobiotic rats which were challenged by monocontamination with enterotoxigenic strains of E. coli. Water transport was evaluated by the in vivo marker perfusion technique at weekly intervals over a 3-week period after contamination. Water transport in unimmunized control rats was consistently in absorption in those contaminated by a nontoxigenic strain, in secretion during only week 2 in those contaminated by an LT(+)/- strain, in secretion during weeks 2 and 3 in those contaminated by an LT(+)/ST(+) (heat-stable enterotoxin) strain, and consistently in absorption in those contaminated by an -/ST(+) strain. Rats immunized with a booster dosage of 250 mug had a significant increase (P < 0.001) in net water absorption as compared to unimmunized rats, with values in the borderline range of absorption, when challenged with either the LT(+)/- or LT(+)/ST(+) strains. Rats immunized with a 10-fold-higher boosting dosage had a significant increase (P < 0.001) in net water absorption as compared to those boosted at the lower dosage; water absorption was within the normal range. There was no difference between the ileal bacterial counts of unimmunized and immunized rats challenged by the various strains. These observations indicate that this immunization program provides complete protection in an animal model against challenge by intestinal contamination with enterotoxigenic strains of E. coli which produce LT, either alone or in combination with ST.

Influence of route of administration on immediate and extended protection in rats immunized with Escherichia coli heart-labile enterotoxin

The effect of route of administration, dosage, and number of boosts employed during immunization with the polymyxin-release form of Escherichia coli heat-labile (LT) enterotoxin on the degree and duration of protection afforded was evaluated in rats which were challenged by the ligated loop technique. Increasing the boosting dosage by fivefold from 50 to 250 mug resulted in a marked increase in protection against challenge with toxin in rats immunized either just by the parenteral route (i.p./i.p.) or by a parenteral prime, followed by peroral boosts (i.p./p.o.) in rats pretreated with cimetidine to ablate gastric secretions; such was not the case, however, even with a 50-fold increase in dosage in rats immunized just by the peroral route (p.o./p.o.). Four weekly peroral boosts were required to achieve the strongest degree of protection. Increasing the boosting dosage also increased the degree of protection against challenge with viable LT(+)/ST(-) and LT(+)/ST(+) strains (ST indicates heat-stable enterotoxin) in rats immunized by the i.p./p.o., but not by the i.p./i.p., route; no protection was evident against an LT(-)/ST(+) strain. Protection was lost within 3 weeks after immunization in rats immunized by the i.p./i.p. route. In contrast, protection was extended over the 3-month observation period in those immunized by the i.p./p.o. route; the degree of protection was enhanced in rats which received an additional boost at 2 months. These observations establish the fact that immunization with LT is similar to that with cholera toxin in that arousal of the local immune intestinal response by means of peroral immunization provides maximal extended protection.

Protective effect of active immunization with purified Escherichia coli heat-labile enterotoxin in rats

The protective effect of active immunization by different routes with a purified preparation of the polymyxin-release form of Escherichia coli heat-labile toxin was evaluated in rats. Immunized animals were challenged by placing toxin into ligated ileal loops at dosages which produced either 50% or the maximum secretory response in unimmunized rats. Immunization exclusively by the parenteral route yielded significant protection. Rats were also protected when parenteral priming was followed by boosting given either directly into the duodenum or perorally 2 h after intragastric cimetidine, but not when the peroral boosts were given with bicarbonate. Immunization administered entirely by the peroral route with cimetidine yielded protection but only when the immunizing dosage was fivefold greater than that found effective in the parenteral-peroral approach. Rats immunized exclusively by the parenteral route and those boosted perorally with cimetidine were also tested, and found to be protected, against challenge with viable organisms of strains that produce either heat-labile toxin alone or both heat-labile and heat-stable toxin, but they were not protected against a strain which produces just heat-stable toxin. Geometric mean serum antibody titers were increased by 16-fold or more over control values in those groups of rats in which protection was achieved, with the exception of those immunized exclusively by the peroral route. These observations demonstrate that (i) active immunization with purified E. coli heat-labile toxin results in significant protection against both this toxin as well as viable organisms which produce it, but not against viable strains which produce heat-stable toxin only, and (ii) concomitant ablation of gastric secretion by the use of cimetidine renders the peroral route of immunization effective. They suggest that prophylactic immunization against diarrheal disease caused by heat-labile toxin-producing strains of E. coli may be feasible in humans.

Demonstration of shared and unique immunological determinants in enterotoxins from Vibrio cholerae and Escherichia coli

Immunodiffusion and biological neutralization studies demonstrated that the heat-labile enterotoxin (LT) from Escherichia coli has antigenic determinants in common with each of the isolated subunits (A and B) of the enterotoxin (choleragen) from Vibrio cholerae. Each of the enterotoxins also possesses unique antigenic specificities. Monospecific antiserum to LT was prepared by immunization with antigens derived by immune precipitation of E. coli cell-free supernatant with isolated specific anticholeragenoid antibodies. This antiserum neutralized the biological acitivity of both LT and cholera enterotoxin and recognized antigens of both in immunodiffusion. This antiserum was adsorbed with choleragenoid to remove antibodies directed against the shared "B" immunological determinants. The neutralizing effect of the antiserum on cholera toxin was completely removed, but the neutralizing activity against the E. coli preparations was retained, although somewhat reduced. Antisera to the isolated subunits (A and B) of cholera enterotoxin neutralized the biological activity of cholera enterotoxin and LT. These antisera also recognized the homologous and heterologous antigens in immunodiffusion. Multiple forms or conformations of LT and its components may explain the diversity of the properties which have been reported for it.

Cytotoxic activity of Aeromonas hydrophila

Most strains of Aeromonas hydrophila tested demonstrated cytotoxic activity on several tissue-cultured cell lines. The cytotoxin is heat-labile, non-dialyzable, and immunologically distinct from that of Shigella dysenteriae and Clostridium perfringens. None of the aeromonas isolates was found to be enterotoxigenic by either tissue culture or rabbit ileal loop assays.

Immunological relationship of different preparations of coliform enterotoxins

Antisera raised in rabbits to ultrafiltrate toxin preparations containing either the heat-labile (LT) toxin form obtained from whole cell lysates or broth filtrates or the heat-stable (ST) toxin form prepared from broth filtrates from nontoxigenic and toxigenic strains of Escherichia coli and Klebsiella were examined for their ability to neutralize the secretory effect on water transport of these toxins in the rat jejunum as determined by the in vivo marker perfusion technique. Antisera to the heat-labile toxin derived from whole cell lysate preparations from nontoxigenic strains had no neutralizing effect. Antisera to both types of LT preparation from both toxigenic strains neutralized, with several exceptions, all of the homologous and heterologous LT toxins as well as a heat-labile toxin preparation derived from sequential ultrafiltration of cell-free whole cell lysates which had a defined molecular weight of between 30,000 and 100,000. These antisera also neutralized homologous and heterologous ST preparations obtained from broth filtrates, but they had no neutralizing effect on low-molecular-weight, ST toxin material obtained during the sequential ultrafiltration of cell lysates. Antisera to ST prepared from broth filtrates had no neutralizing capacity against either LT or ST toxin preparations. These observations (i) indicate that the immunological relationship of E. coli and Klebsiella LT and ST toxins extends to antisera raised against LT prepared by several different methods, (ii) raise the possibility that, based on the response to antisera to LT, there may be several immunologically heterogeneous forms of low-molecular-weight ST toxin, and (c) confirm the lack of immunogenicity of ST.

Immunological cross-reactivity between a heat-labile enterotoxin(s) of Escherichia coli and subunits of Vibrio cholerae enterotoxin

Heat-labile enterotoxin from Escherichia coli is immunologically related to both subunits, A and B, of cholera enterotoxin as demonstrated by neutralization and immunodiffusion.

Activation of adenylate cyclase by heat-labile Escherichia coli enterotoxin. Evidence for ADP-ribosyltransferase activity similar to that of choleragen

Highly purified, polymyxin-released, low molecular weight Escherichia coli heat-labile enterotoxin (LT) catalyzed the hydrolysis of NAD to ADP-ribose and nicotinamide. This NAD glycohydrolase activity was stimulated by dithiothreitol and was independent of cellular components. Nicotinamide formation was enhanced by arginine methyl ester > d-arginine congruent with l-arginine congruent with guanidine. A 20-fold increase in activity was noted with arginine methyl ester, and maximal activity again required dithiothreitol. When the reaction was initiated with toxin, a delay was observed before a constant rate was established. The reaction products found after incubation of [adenine-U-(14)C]NAD and l-[(3)H]arginine or unlabeled arginine methyl ester with the enterotoxin had mobilities on thin-layer chromatograms similar to the reaction products obtained after incubation of choleragen with these substrates and are consistent with the formation of ADP-ribose-l-arginine and ADP-ribose-l-arginine methyl ester, respectively. Both toxins, which catalyze the NAD-dependent activation of adenylate cyclase, thus appear to possess NAD glycohydrolase and ADP-ribosyltransferase activities. Although the activities of both toxins are dependent on dithiothreitol, Escherichia coli enterotoxin exhibited optimal activity in Tris (Cl(-)) (pH 7.5) and was inhibited by high concentrations of potassium phosphate (pH 7.0) or low pH (sodium acetate, pH 6.2). It appears that the optimal assay conditions as well as the kinetic constants for the reactants differ from those previously noted with choleragen. It is probable therefore that although the two toxins catalyze similar reactions, they differ in primary structure. The presence of transferase and glycohydrolase activities in structurally distinct toxins that activate adenylate cyclase strengthens our hypothesis that the ADP-ribosylation of arginine is a model for the NAD-dependent activation of adenylate cyclase; activation may result from ADP-ribosylation of the cyclase itself or of a protein that regulates its activity.

Mechanism of action of choleragen

Choleragen exerts its effect on cells through activation of adenylate cyclase. Choleragen initially interacts with cells through binding of the B subunit of the toxin to the ganglioside GM1 on the cell surface. Subsequent events are less clear. Patching or capping of toxin on the cell surface may be an obligatory step in choleragen action. Studies in cell-free systems have demonstrated that activation of adenylate cyclase by choleragen requires NAD. In addition to NAD, requirements have been observed for ATP, GTP, and calcium-dependent regulatory protein. GTP also is required for the expression of choleragen-activated adenylate cyclase. In preparations from turkey erythrocytes, choleragen appears to inhibit an isoproterenol-stimulated GTPase. It has been postulated that by decreasing the activity of a specific GTPase, choleragen would stabilize a GTP-adenylate cyclase complex and maintain the cyclase in an activated state. Although the holotoxin is most effective in intact cells, with the A subunit having 1/20th of its activity and the B subunit (choleragenoid) being inactive, in cell-free systems the A subunit, specifically the A1 fragment, is required for adenylate cyclase activation. The B protomer is inactive. Choleragen, the A subunit, or A1 fragment under suitable conditions hydrolyzes NAD to ADP-ribose and nicotinamide (NAD glycohydrolase activity) and catalyzes the transfer of the ADP-ribose moiety of NAD to the guandino group of arginine (ADP-ribosyltransferase activity). The NAD glycohydrolase activity is similar to that exhibited by other NAD-dependent bacterial toxins (diphtheria toxin, Pseudomonas exotoxin A), which act by catalyzing the ADP-ribosylation of a specific acceptor protein. If the ADP-ribosylation of arginine is a model for the reaction catalyzed by choleragen in vivo, then arginine is presumably an analog of the amino acid which is ADP-ribosylated in the acceptor protein. It is postulated that choleragen exerts its effects on cells through the NAD-dependent ADP-ribosylation of an arginine or similar amino acid in either the cyclase itself or a regulatory protein of the cyclase system.