Exotoxin A of Pseudomonas aeruginosa is a secreted bacterial toxin capable of translocating a catalytic domain into mammalian cells and inhibiting protein synthesis by the ADP-ribosylation of cellular elongation factor 2. The protein is a single polypeptide chain of 613 amino acids. The x-ray crystallographic structure of exotoxin A, determined to 3.0-A resolution, shows the following: an amino-terminal domain, composed primarily of antiparallel a8-structure and comprising approximately half of the molecule; a middle domain composed of a-helices; and a carboxyl-terminal domain comprising approximately one-third of the molecule. The carboxyl-terminal domain is the ADP-ribosyltransferase of the toxin. The other two domains are presumably involved in cell receptor binding and membrane translocation.Exotoxin A of Pseudomonas aeruginosa is one member of a family of secreted bacterial toxins that are capable of covalently modifying specific target proteins within mammalian cells (1). Included in this family are the exotoxins of Corynebacterium diphtheriae (diphtheria toxin) and Vibrio cholerae (cholera toxin), Escherichia coli heat-labile toxin (LT), and exotoxins of Shigella dysenteria (shiga toxin) and Bacillus anthracis (anthrax toxins) as well as exotoxin A (2). Despite their diversity in size, subunit composition, cell specificity, and enzymatic activity, these toxins appear to share a similar multistep mechanism in which (i) the toxin binds to a receptor on the membrane surface of a target cell; (ii) the catalytic domain of the toxin is translocated into, or at a minimum into contact with, the cell cytoplasm; (iii) the catalytic moiety is then able to modify its target substrate. The toxins thus must have a receptor binding activity, a membrane translocation mechanism, and an enzymatic domain. It is characteristic that the receptor binding function and the enzymatic activity reside in separate structural components of the molecules, in separate subunits of an oligomer (cholera toxin, LT, shiga toxin) (3-5), in separate proteins (anthrax system) (6), or within a single monomeric polypeptide (diphtheria toxin, exotoxin A) (7,8).Several of the toxins (cholera toxin, LT, diphtheria toxin, and exotoxin A) catalyze transfer of the ADP-ribose moiety of oxidized nicotinamide adenine dinucleotide (NAD+) to target substrates (9-12). Diphtheria toxin and exotoxin A specifically ADP-ribosylate a modified histidine (diphthamide) of protein synthesis elongation factor 2, thereby inactivating the elongation factor and terminating peptide chain elongation in a target cell (13).Several intriguing mechanistic questions arise: (i) What are the mechanisms of membrane translocation by which the toxic factors enter the target cell cytoplasm? (ii) How is the membrane translocation and enzymic activation process controlled during intoxication? (iii) What is the mechanism of the ADP-ribosyltransferase reaction? Little structural information is available for members of this class of bacterial toxins. Crystals suitable for high re...