Thermostable direct hemolysin (TDH) is a major virulence factor of Vibrio parahaemolyticus that causes pandemic foodborne enterocolitis mediated by seafood. TDH exists as a tetramer in solution, and it possesses extreme hemolytic activity. Here, we present the crystal structure of the TDH tetramer at 1.5 Å resolution. The TDH tetramerformsacentralporewithdimensionsof23Å indiameterand ϳ50 Å in depth. -Cation interactions between protomers comprising the tetramer were indispensable for hemolytic activity of TDH. The N-terminal region was intrinsically disordered outside of the pore. Molecular dynamic simulations suggested that water molecules permeate freely through the central and side channel pores. Electron micrographs showed that tetrameric TDH attached to liposomes, and some of the tetramer associated with liposome via one protomer. These findings imply a novel membrane attachment mechanism by a soluble tetrameric pore-forming toxin.Vibrio parahaemolyticus is a Gram-negative marine bacterium known to be one of the major causes of pandemic seafoodborne gastroenteritis. V. parahaemolyticus possesses two circular replicons of 3.2 and 1.9 megabase pairs, which might confer an advantage by enabling DNA replication in seawater of lower temperature and/or low nutritional value (1, 2). Such an advantage would potentially increase risks of food intoxication by allowing explosive expansion of the population of the microorganism. Hemolysis on Wagatsuma agar (a blood agar), known as the Kanagawa phenomenon, is associated with human pathogenic strains of V. parahaemolyticus. A major virulence factor of this pathogen is the thermostable direct hemolysin (TDH) 7 (3-5), which has a variety of biological activities including hemolytic activity, cardiotoxicity, and enterotoxicity. There are two copies of the tdh gene (or its homologue trh) in pathogenic V. parahaemolyticus, indicating the importance of this exotoxin for survival of the organism (2). The mature form of TDH consists of 165 amino acids, including a single intramolecular disulfide bond, but no close homologue of TDH has been found in other organisms. The significance of Arg 46 , Gly 62 , Trp 65 , and Gly 90 residues on hemolysis was determined by site-directed mutagenesis (3, 6).The common features of the bacterial pore-forming toxin are as follows. 1) It is released as a soluble monomer into the extra-bacterial space. 2) It oligomerizes to form a pore at the host cell membrane (7,8). An earlier study reported that TDH acted as a pore-forming toxin, creating a functional pore ϳ20 Å in diameter (reviewed in Ref. 3). We previously constructed a low resolution C 4 symmetric model of tetrameric TDH in solution based on small angle x-ray scattering (SAXS), transmission electron microscopy (TEM), and analytical ultracentrifugation (9). However, the precise structure and the mechanism for its pore-forming toxicity are still unknown. Several bacterial toxins, including TDH, show paradoxical responses to heat treatment, known as the Arrhenius effect (10, * This study was s...