Domain III of Pseudomonas aeruginosa exotoxin A catalyses the transfer of ADP-ribose from NAD to a modified histidine residue of elongation factor 2 in eukaryotic cells, thus inactivating elongation factor 2. This domain III is inactive in the intact toxin but is active in the isolated form.We report here the 2.5-A crystal structure of this isolated domain crystallized in the presence of NAD and compare it with the corresponding structure in the intact Pseudomonas aeruginosa exotoxin A. We observe a significant conformational difference in the active site region from Arg-458 to Asp-463. Contacts with part of domain II in the intact toxin prevent the adoption of the isolated domain conformation and provide a structural explanation for the observed inactivity. Additional electron density in the active site region corresponds to separate AMP and nicotinamide and indicates that the NAD has been hydrolyzed. The structure has been compared with the catalytic domain of the diphtheria toxin, which was crystallized with ApUp.Pseudomonas exotoxin A (PE) is a 66-kDa, 613-amino acid protein that is secreted by the bacterium Pseudomonas aeruginosa as one of its virulence factors (1, 2). The toxin binds to eukaryotic cells via the ubiquitous a2-macroglobulin receptor (3), and enters the cells by receptor-mediated endocytosis. Once in the cells, the toxin is cleaved by a specific protease and, after reduction of a disulfide bond (4), a C-terminal fragment (aa 280-613) is released and subsequently translocated to the cytosol, where it catalyzes the irreversible inactivation of eukaryotic elongation factor 2 (eEF-2) by ADP-ribosylation of a modified histidine (diphthamide) residue, leading to the arrest of protein synthesis and eventually to cell death (1, 5).The crystallographic determination of the PE structure has shown that PE is made up of three domains (6) and that there is a correspondence between the structural and the functional boundaries of the domains. Domain Ia (aa 1-252) is responsible for cell recognition. Removal of domain Ia or a specific point mutation at position 57 results in an inactive toxin due to its inability to bind to cells (7). Domain II (aa 253-364) is involved in the translocation of the toxin across intracellular membranes. The function of domain Ib (residues 365-399) has not been elucidated. Removal of part of domain lb (aa 365-380) results in a truncated but fully functional toxin (8). Domain III (aa 400-613) catalyzes the ADP-ribosylation of eEF-2 with the five C-terminal residues (REDLK) serving as an endoplasmic reticulum retention signal (9, 10). The functional boundary between domain lb and domain III is located at residue 400 (8).The ADP-transfer reaction catalyzed by domain III has been proposed to include formation of a binary complex of NAD and PE, binding of eEF-2 to the binary complex, and transfer of the ADP-ribose moiety of NAD to the diphthamide of eEF-2 as follows (11): PE NAD+ + eEF-2 ADP-ribose-eEF-2 + nicotinamide + H+.In the absence of eEF-2, a weak NAD-glycohydrolase a...