A hemolytic toxin related to thermostable direct hemolysin (TDH), TDH-related hemolysin (TRH), produced by Kanagawa-phenomenon-negative Vibrio parahaemolyticus is suspected of playing an important, but yet-tobe-elucidated role in diarrhea caused by this organism. In cultured human colonic epithelial cells, TRH increases Cl ؊ secretion, followed by elevation of intracellular calcium.Vibrio parahaemolyticus is an important cause of gastroenteritis, with outbreaks now occurring all over the world (2, 17). However, the mechanisms underlying the diarrheic action of this pathogen are not completely understood. V. parahaemolyticus can be categorized according to the presence or absence of the Kanagawa phenomenon (KP), in which there is hemolysis due to thermostable direct hemolysin (TDH) produced by the organism on Wagatsuma agar medium (14). TDH has been considered a major virulence factor for this disease (8, 23); however, some cases of V. parahaemolyticus gastroenteritis are due to KP-negative strains (10,15,16). From clinically isolated KP-negative V. parahaemolyticus, we identified a new hemolysin, named TDH-related hemolysin (TRH), and demonstrated that this TRH was also an important virulence factor (10, 24). For example, TRH stimulated fluid secretion in the rabbit loop test (8, 10). Thus, there is a possibility that TRH induces diarrhea. TRH is immunologically related, but not identical, to TDH ordinary human virulence factor. Unlike that of TDH, the activity of TRH is labile to heat treatment at 60°C for 10 min (10). Although we recently demonstrated that TDH induced Cl Ϫ secretion in human colonic epithelial cells (22), there is no evidence how TRH induces fluid secretion. (175, 83, 62, 47.5, 32.5, 25, 16.5, and 6.5 kDa); lane 2, TRH. (B) Effect of gluconate ion and Ca 2ϩ depletion on Isc in Caco-2 cell monolayers. F, Control cells (simple exposure to TRH); s, Cl Ϫ replaced by gluconate ion in bath solution of Ussing chamber; OE, CaCl 2 was omitted from bath solution and EGTA (1 mM) was added to bath solution of Ussing chamber. TRH was added on the apical side of the Caco-2 cells at the time indicated. , negative control (no exposure to TRH). Values are expressed as means Ϯ standard deviations (n ϭ 5). ,ء Significant difference (P Ͻ 0.05) versus negative control.