The repeats-in-toxin (RTX) exoproteins are a diverse collection of proteins exported via type I secretion by gram-negative bacteria. These proteins include the pore-forming RTX toxins typified by ␣-hemolysin of Escherichia coli and Bordetella pertussis adenylate cyclase toxin (ACT) and also secreted enzymes such as metalloproteases and lipases, S-layer proteins, a nodulation signaling factor, and the Fe-regulated FrpC "clipand-link" toxin of Neisseria meningitidis (24,27).In 1999, a new toxin from Vibrio cholerae was discovered that was initially categorized in the RTX toxin family and simply named "the RTX toxin" or VcRtxA (22). This toxin is produced by nearly all clinical and environmental isolates of V. cholerae, including the El Tor O1 strains responsible for the current cholera pandemic plus a broad selection of O139 and non-O1/non-O139 strains (7, 9, 10, 13). The toxin has been associated with increased epithelial cell damage in a mouse lung infection model (14) and has also been associated with increased virulence in a mouse gut infection model, although its role in intestinal disease is currently unclear (26). Recently, a related toxin from Vibrio vulnificus has been described and found to be important for virulence in mouse models (21, 23).On-going study of the mechanism of action of the V. cholerae toxin in vitro has revealed that it is a totally novel type of toxin with many features that distinguish it from other RTX toxins. In addition, release of genomic sequences from human, marine, and insect pathogens has indicated that the toxins from V. cholerae and V. vulnificus are not unique but rather are the first characterized members of a new family of the RTX exoproteins. Within this new family, the structural properties of the toxins are highly conserved, but the catalytic activities carried are predicted to vary since the toxins are assembled as mosaics of 10 activity domains assorted among the various toxins.In this review, the structure and function of the V. cholerae toxin are discussed in detail, revealing that this is a novel toxin distinct from the other RTX toxins. The structural features that define the new family and the mosaic structure of the activity domains are also discussed. Overall, it is shown that the V. cholerae toxin is a multifunctional autoprocessing RTX toxin, renamed MARTX Vc , that represents a larger group of MARTX toxins produced by at least eight gram-negative species.
NOVEL REPEAT STRUCTURE OF MARTX TOXINSA common property of all RTX pore-forming toxins is their large size; their molecular masses range from 100 to 177 kDa (24). At the C terminus of these large proteins are "GD-rich" nonapeptide repeats (GGXGXDX[L/I/V/W/Y/F]X], where X is any amino acid), which are the defining characteristic of the RTX exoproteins (20). These repeats have been shown to fold to form a stable -roll structure that binds Ca 2ϩ (3) and are thought to be involved in proper insertion of the toxins into the eukaryotic cytoplasmic membrane (29).Sequences of novel A, B, and C repeats. The MARTX V...