A number of bacterial pathogens utilize the type III secretion pathway to deliver effector proteins directly into the host cell cytoplasm. Certain strains of Pseudomonas aeruginosa associated with acute infections express a potent cytotoxin, exoenzyme U (ExoU), that is delivered via the type III secretion pathway directly into contacting host cells. Once inside the mammalian cell, ExoU rapidly lyses the intoxicated cells via its phospholipase A 2 (PLA 2 ) activity. A high-throughput cell-based assay was developed to screen libraries of compounds for those capable of protecting cells against the cytotoxic effects of ExoU. A number of compounds were identified in this screen, including one group that blocks the intracellular activity of ExoU. In addition, these compounds specifically inhibited the PLA 2 activity of ExoU in vitro, whereas eukaryotic secreted PLA 2 and cytosolic PLA 2 were not inhibited. This novel inhibitor of ExoU-specific PLA 2 activity, named pseudolipasin A, may provide a new lead for virulence factor-based therapeutic design.Pseudomonas aeruginosa is the leading cause of hospitalacquired infections by gram-negative bacteria and is responsible for chronic infections of individuals with cystic fibrosis (15). As P. aeruginosa and other bacterial pathogens become multidrug resistant (22), there is a continual need for the identification of compounds directed at novel targets that could be developed into therapeutic agents. The ability of P. aeruginosa to cause a number of distinct infections has been attributed to its large genome, which encodes a variety of virulence factors (35). Prominent among these is the type III secretion system (TTSS), which allows the bacteria to deliver proteins directly into the host cell cytoplasm (39). ExoU is one of the toxic effector proteins delivered by the type III secretion apparatus, and its expression is associated with strains that cause acute infections (11,12). ExoU is a member of the patatin family of phospholipase A 2 (PLA 2 ), and this activity is required for cytotoxicity toward eukaryotic cells (33,34). In contrast to eukaryotic phospholipases, which remodel cellular membranes and synthesize proinflammatory secondary messengers such as arachidonic acid and leukotrienes (2, 9), ExoU PLA 2 activity primarily causes disruption of the host cytoplasmic membrane, resulting in cell lysis (24,32,33).We sought to identify compounds that inhibit type III secretion-mediated cytotoxicity by protecting tissue culture cells from infection by P. aeruginosa strains that elaborate ExoU as a sole cytotoxic effector. From a synthetic small-molecule library, we have identified compounds that protected Chinese hamster ovary (CHO) cells from the cytotoxic activity of P. aeruginosa expressing ExoU. One of the most potent compounds is pseudolipasin A (Pseudomonas phospholipase inhibitor A). Pseudolipasin A does not interfere with type III secretion in general, suggesting that the protection observed occurs downstream of the delivery of ExoU. Pseudolipasin A not only protected...