Campylobacterjejuni is able to colonize the human intestinal mucosa and cause disease. For this reason, it was important to investigate mechanisms by which C. jejuni adheres to epithelial cells and intestinal mucus gel. All strains of C. jejuni used were able to adhere to INT 407 epithelial cells and mucus, but high adherence to one substrate did not necessarily indicate comparable adherence to the other. The adherence of C. jejuni to cells was inhibited partially by treating the bacterial cells with proteases or glutaraldehyde or by adding a certain carbohydrate (fucose or mannose) to the medium. The flagellum of C. jejuni was identified as a potential adhesin by comparing adherence of flagellated and aflagellated variants. Shearing of the bacterial cells to remove the flagella reduced bacterial adhesion, whereas immobilization of the flagellum with KCN increased adhesion. Purified flagella showed specific, fucose-resistant binding to epithelial cells but not to intestinal mucus. The presence of a second, nonproteinaceous adhesin was suggested because no single treatment of the bacteria completely inhibited adhesion. Lipopolysaccharide (LPS) was identified as another C. jejuni adhesin. [3H]LPS specifically bound to epithelial cells, and this phenomenon was inhibited by periodate oxidation of the LPS or glutaraldehyde fixation of the epithelial cells. LPS, unlike flagella, was fucose sensitive and inhibited binding of whole bacterial cells to INT 407 cells. LPS was also able to bind to intestinal mucus gel. These data indicate that both flagella and LPS are important in adhesion to the mucosal surface. Campylobacter jejuni is a frequent agent of diarrhea in humans (5), yet the interplay of its virulence factors in pathogenesis is poorly understood. The mechanisms by which C. jejuni interacts with the intestinal mucosa and initiates diarrhea are also unclear. Adhesion of bacteria to mucosal surfaces is necessary for colonization and subsequent pathogenesis. This process is mediated by chemotactic factors (9) and bacterial appendages (adhesins) which can include pili, flagella, capsules, glycocalyces, lipopolysaccharides, and cell-associated lectins (1, 2, 7). Complete evaluation of adhesion mechanisms of many organisms, however, has only recently begun. Newell and Pearson (24) used scanning electron microscopy to demonstrate in vitro adherence of C. jejuni to intestinal epithelial cells and saw morphologic evidence that this adhesion could be mediated by flagella. Later, flagellated organisms were shown to adhere in greater numbers to cells than did an aflagellated variant (23). Dijs and De Graaf (8) showed that C. jejuni cells do not possess fimbriae or pili but are able to agglutinate a variety of mammalian erythrocytes. Later, Naess et al. (22) were able to show in vitro adherence of C. jejuni strains to porcine small intestinal brush border preparations. Cinco et al. (6) also studied Campylobacter adherence to intestinal epithelial cells. The adhesion was inhibited partially by L-fuCose and D-mannose. This sug...