1. Introduction
Most of the toxins produced by
TpeL, a recently-described novel member of the family of large clostridial cytotoxins, was found in
2. The family of clostridial glucosylating toxins
Cytosolic mono-O-glucosylation is an important molecular mechanism by which various bacterial protein toxins and effectors target eukaryotic cells.
2.1. Structure of LCTs
LCTs are single protein chains containing four functional domains and share 26 to 76 % sequence identity and are structurally and functionally organized (Busch and Aktories 2000). LCTs are composed of four domains, the glucosylating enzymatic A-domain, the autocatalytic processing C-domain, the translocating D-domain and the binding B-domain (Fig. 1). The one third C-terminal part exhibits multiple repeated sequences (31 short repeats and 7 long repeats in TcdA), which are involved in the recognition of a cell-surface receptor. A trisaccharide (Gal-α1-3Gal-β1-4GlcNac) has been found to be the motif recognized by TcdA. Related carbohydrates could be involved as TcdA receptor. The gp96, a member heat shock protein family, has been proposed to bind TcdA to the plasma membrane of enterocytes (Na et al. 2008). Because this B-domain exhibits sequence similarity to the carbohydrate binding region of the glucosyltransferase from

Figure 1.
Domain organization of clostridial glucosylating toxins.
Clostridial glucosylating toxins are composed of four domains, the glucosylating enzymatic domain (A-domain), the autocatalytic processing domain (C-domain), the translocating domain (D-domain) and the binding domain (B-domain). The A-domain has the glucosyltransferase activity. The B-domain containing polypeptide repeats is responsible for specific receptor-binding. The C-domain participates in the auto-catalytic cleavage of LCTs and is a cysteine-protease with the catalytic residues DHC. InsP6 is required for activation of the cysteine protease. The D-domain is likely involved in the delivery of the A-domain into the cytosol. This domain includes a hydrophobic region suggested to be important for insertion of the toxin into endosome membranes.
TcdA has been determined (Ho et al. 2005, Greco et al. 2006), showing a solenoid-like structure with 32 repeats consisting of 15–21 amino acid residues and seven repeats consisting of 30 residues. The repeats form β-hairpins, arranged in pairs with each adjacent pair of hairpins rotated by 120° to the next pair, resulting in a screw-like structure of a left-handed β-solenoid helix (Greco et al. 2006). Co-crystallization with a derivate of the trisaccharide α-Gal(1,3)β-Gal(1,4)βGlcNAc confirmed the carbohydrate binding capacity of the domain. In this complex there are two carbohydrate-binding regions. However, in the full-length C-terminal fragment there are seven of these potential binding domains that are highly conserved, giving it a high binding capacity. Although there is little information about the binding domain of TcdB, it is believed that TcdB uses different receptors to bind to target cell surfaces than TcdA (Jank et al. 2007a).
The cysteine protease C-domain is located between residues 543 and 769 in TcdA and between residues 543 and 767 in TcdB (Egerer et al. 2007, Giesemann et al. 2008). It was shown that cleavage of the toxin occurs auto-catalytically by a cysteine protease activity, which is harbored in the C-domain, covering residues 544–955, directly down-stream of the glucosyltransferase domain (Egerer et al. 2007, Giesemann et al. 2008). Cys-698 and His-653 have been shown to be part of the catalytic dyad, which in addition to Asp-587 might participate in the auto-cleavage reaction (Egerer et al. 2007). The crystal structure of C-domain (543–809) from TcdA was resolved in the presence of inositol hexakisphosphate (InsP6) (Pruitt et al. 2009). InsP6 binds to the C-Domain, causing a conformational change that activates the auto-catalytic activity (Egerer et al. 2009). This locates between the enzymatic A-domain and the delivery D-domain, playing a role in proteolytic cleavage of the toxin. The toxins undergo autoproteolysis allowing only the enzymatic A-domain to be released into the cytosol in the presence of InsP6. Once the target cell has taken up the LCT via receptor-mediated endocytosis at the B-domain, the toxin undergoes autoproteolysis in order to allow the A-domain to pass across the endosomal membrane into the cytosol (Kreimeyer et al. 2011).
D-domain, which is located between residues 955 and 1852, is a large hydrophobic region that makes up almost 50% of the total size of the toxin (Barth et al. 2001, Qa'Dan et al. 2000). However, the exact function of D-domain is unknown. It is characterized by a hydrophobic stretch which is most probably responsible for membrane penetration (transmembrane prediction) (von Eichel-Streiber et al. 1992). Therefore, this region is speculated to as the translocation domain. Deletion studies proved the importance of the hydrophobic region for toxin activity (Barroso et al. 1994). A small region in the primary sequence between residues 965 and 1128 is characterized by hydrophobic amino acids and is suggested to play a role in formation of transmembrane structure during pore formation and translocation of the toxin into the cytosol (Voth and Ballard 2005). Pore formation induced by the toxin has been shown in artificial lipid membranes (Barth et al. 2001, Giesemann et al. 2006). However, so far it is not clear how pore formation relates to the delivery of the toxin into the cytosol.
The biologically active domain, A-domain, harboring the glucosyltransferase activity, is translocated into the cytosol, comprises the first 543 aa (Pfeifer et al. 2003, Rupnik et al. 2005). Therefore, cleavage of the toxin is required. The 3D-structure of A-domain showed that it was closely related to other bacterial glucosyltransferases belonging to the glucosyltransferase A family (Reinert et al. 2005). The catalytic core consists of 234 aa and is formed by a mixed α/β-fold with mostly parallel β-strands as the central part. The more than 300 additional residues are mainly helices, of which the first four N-terminal helices are most probably involved in membrane association, therefore assuring close proximity of the enzyme with its substrates. The structure of the central core is similar to that of glucosyltransferase A family (Reinert et al. 2005, Ziegler et al. 2008). Characteristic for glucosyltransferase A family members is the DXD motif involved in complexation of manganese ions, UDP and glucose. Mutation of these essential aspartate residues leads to inactivation of the toxin (Giesemann et al. 2008). The first aspartic residue of the DXD motif binds to ribosyl and glucosyl moieties of UDP-glucose and the second aspartic residues binds to divalent cation (mainly manganese ions) which increases the hydrolase activity and/or the binding of UDP-glucose (Just et al. 2000). Other amino acids in TcdB having an essential role in the enzymatic activity have been identified such as Trp-102 which is involved in the binding of UDP-glucose, Asp-270, Arg-273, Tyr-284, Asn-384, Trp-520, as well as Ile-383 and Glu-385 being important for the specific recognition of UDP-glucose (Busch et al 2000a and 2000b, Jank et al. 2005, Jank et al. 2007a,). Differences in α-helices probably account for the substrate specificity of each toxins (Reinert et al. 2005, Ziegler et al. 2008). Chimeric molecules between TcdB and TcsL have been used to identify the sites of Rho-GTPase recognition. Amino acids 408 to 468 of TcdB ensure the specificity for Rho, Rac and Cdc42, whereas in TcsL, the recognition of Rac and Cdc42 is mediated by residues 364 to 408, and that of Ras proteins by residues 408 to 516 (Voth and Ballard 2005, Jank et al. 2007a). The four N-terminal helices which mediates the binding of TcsL to phosphatidylserine, are possibly involved in membrane interaction (Mesmin et al. 2004). Amino acids 22-27 of Rho and Ras GTPase which are part of the transition of the α1-helix to the swich 1 region, are the main domain recognized by the glucosylating toxins (Müller et al. 1999). The cosubstrate for the bacterial glucosyltransferases is UDP-glucose; only TcnA utilizes UDP-N-acetylglucosamine (UDP-GlcNAc) (Selzer et al. 1996). This difference in cosubstrate specificity is based on sterical hindrance by bulky amino acids (e.g. Ile383/Gln385 in TcdB) blocking the catalytic pocket for the larger UDP-GlcNAc. In TcnA, small serine and alanine residues at the corresponding positions allow UDP-GlcNAc to enter the catalytic cleft (Jank et al. 2005). Little is known so far about the molecular/structural determinants underlying the differences in substrate recognition by different glucosylating toxins.
2.2. Internalization of LCTs
LCTs enter eukaryotic target cells through receptor-mediated endocytosis according to the ‘short trip model’ of bacterial exotoxin uptake (Sandvig et al. 2004). The cytotoxicity of the toxins are blocked by endosomal and lysosomal acidification inhibitors (monensin, bafilomycin A1, ammonium chloride) and the inhibiting effects can be by-passed by an extracellular acidic pulse (Popoff et al. 1996, Qa'Dan et al. 2000, Barth et al. 2001, Popoff and Bouvet 2009). As shown in Fig. 2, on binding to host cell receptors (Karlsson 1995, Giesemann et al. 2008), the toxins are endocytosed (Voth and Ballard 2005). After endocytosis, the acidification of early endosomes by the vesicular H+-ATPase induces a conformational change characterized by an increase in hydrophobicity, leading to membrane insertion (Qa'Dan et al. 2000, Barth et al. 2001, Voth and Ballard 2005). It reported that at low pH, LCTs induce channel formation in cell membranes and artificial lipid bilyers (Qa'Dan et al. 2000 and 2001, Giesemann et al. 2006). Membrane cholesterol seems critical for TcdA pore formation (Giesemann et al. 2006). Then, the hydrophobic region enables to form a pore through which the catalytic domain can translocate into the cytosol. Pore formation under acidic conditions has been demonstrated for TcdA and B (Barth et al. 2001, Giesemann et al. 2006). The exact mode of translocation remains to determine. The translocation-ligand domain remains associated with endosomal membranes and only the catalytic-DXD domain penetrates into the cytosol (Pfeifer et al. 2003, Rupnik et al. 2005). The N-terminal catalytic domain (A-domain) is then delivered from the early endosomes into the cytosol by auto-proteolytic activity stimulated by InsP6 (Reineke et al. 2007, Egerer et al. 2007). This autoproteolytic activity is induced by InsP6 and/or dithiothreitol and is responsible for the separation of the catalytic domain from the holotoxin (Egerer et al. 2007, Reineke et al. 2007). A cysteine protease domain (C-domain containing putative catalytic residues, DHC) has been identified close to the cutting site in TcdB (amino acid 544-955), which is conserved in all LCTs (Egerer et al. 2007, Reineke et al. 2007, Egerer et al. 2009). Cys-700, His-655 and Asp-589 have been identified as the catalytic triad. It reported that a cysteine protease catalytic triad is involved in processing of the toxin and auto-cleavage is essential for toxin activity (Egerer et al. 2007). Following its translocation and release, the catalytic-DXD fragment (A-domain) acts on its cytosolic targets, the GTPases of the Rho/Rac family, leading to the observed blockade of signal transduction processes and, consequently, the disaggregation of the cytoskeleton and cell death (Just and Gerhard 2004, Belyi and Aktories 2010). TcdA and B target Rho GTPases (Rho, Ras and Cdc42), which are molecular switches involved in numerous signal processes, in particular, the regulation of the actin cytoskeleton. Once the toxins enter the cytosol, they catalyse the addition of UDP-Glc (UDP-glucose) to Thr-37 (monoglucosylation) in Rho GTPase leading to depolymerization of actin filaments, disruption of the cytoskeleton and eventually cell rounding and cell death (Jank et al. 2007b, Belyi and Aktories 2010) (Fig. 2).
2.3. Glucosylation of Rho GTPase by LCTs
In the cytosol, LCTs glucosylate small GTPases of the Rho and Ras superfamily (Popoff et al. 1996, Selzer et al. 1996, Belyi and Aktories 2010). Small GTP-binding proteins involve organization of the cytoskeleton and control cellular activity of numerous other cellular enzymes. Rho proteins are molecular switches involved in various signal processes, including actin cytoskeleton regulation, cell cycle progression, gene transcription, and control of the activity of many enzymes like protein and lipid kinases, phospholipases, and nicotanimide adenine dinucleotide-oxidase (Etienne-Manneville and Hall 2002, Burridge and Wennerberg, 2004). In respect to their role in host–pathogen interactions, Rho proteins essentially participate in epithelial barrier functions and cell–cell contact, in immune cell
LCTs bind with their B-domain to the receptor of target cells. After endocytosis, the toxin inserts into the endosome membrane most likely involving the hydrophobic part of the D-domain. The acidic pH of the endosome triggers the first conformational change and results in pore formation of the ligand-translocation domain. Cytosolic InsP6 interacts with the cysteine protease C-domain and induces a second conformational change, activating the protease function. This results in cleavage of the toxin and release of the glucosyltransferase A-domain into the cytosol. In the cytosol, Rho GTPases are glucosylated and thereby inactivated. Inactive Rho can not interact with a numerous variety of effectors and induce multiple signaling events.

Figure 2.
Model of entry and intracellular modification of LCTs
Migration, phagocytosis, cytokine production, wound repair, immune cell signaling, and superoxide anion production. Modification of small GTP-binding proteins by LCTs arises at a Thr-35/37, depending on the Rho GTPase isoforms (Fig. 3) (Belyi and Aktories 2010). Marked differences in substrate specificity have been recognized among the various LCTs. TcdA and B glucosylate Rho, Rac and Cdc42 at Thr-37, whereas TcsL glucosylates Ras at Thr-35, Rap, Ral and Rac at Thr-37 and TcsH glucosylates Rho, Rac, Cdc42 (Fig. 4). LCTs catalyze the glucosylation of 21 kDa small GTP-binding proteins from UDP-glucose, except TcnA which uses UDP-N-acetylglucosamine as cosubstrate. TcnA glucosylates Rho, Rac, Cdc42 (Fig. 4). LCTs cleave the cosubstrate and transfer the glucose moiety to the acceptor amino acid of the Rho proteins (Popoff et al. 1996, Popoff and Bouvet 2009, Belyi and Aktories 2010) (Fig. 3). The conserved Thr, which is glucosylated, is located in switch 1. Thr-35/37 is involved in the coordination of Mg2+ and subsequently to the binding of the two phosphates of GTP. The hydroxyl group of Thr-35/37 is exposed to the surface of molecule in its GDP-bound

Figure 3.
Model of glucosyltransferase activity of LCTs.

Figure 4.
Protein substrates and cosubstrates of the LCTs.
TcdA:
2.4. Cellular effects of LCTs.
The inactivation of Rho proteins by LCTs-induced glucosylation causes extensive morphological changes, with loss of actin stress fibers, reorganization of the cortical actin, disrupution of the intercellular junctions and thus increase in cell barrier permeability. The actin cytoskeleton of intoxicated cells is redistributed, causing shrinking and rounding up of most cell types, which is initially accompanied by the formation of neurite-like retraction fibers. Finally, the retraction fibers disappear and the cells detach from the dishes (Ottlinger and Lin 1988, Popoff and Bouvet 2009). Inactivation of Rac assumes to be critical player in disorganization of actin cytoskeleton (Halabi-Cabezon et al. 2008). Numerous other cellular responses to the inactivation of Rho and Ras proteins by LCTs have been described, which are all caused by inhibition of the various functions of the small GTPase. They include inhibition of secretion (Prepens et al. 1996), phospholipase D activity (Schmidt et al. 1996), apoptosis (Brito et al. 2002, Voth and Ballard 2005), chemoattractant receptor signaling (Servant et al. 2000), phagocytosis (Caron and Hall 1998) and alteration of endothelial barrier function (Hippenstiel et al. 1997). However, the role of LCTs on pathogenesis including diarrhea and pseudomembranous colitis are still unknown.
Tissue damage and inhibition of the barrier function of enterocytes might explain the fluid response in toxin-induced diarrhea. TcdA and B affect the morphology and function of tight junctions and associated proteins (ZO-1, ZO-2, occuludin, claudin) to decrease transepithelial resistance, whereas E-cadherin junctions show little alteration (Nusrat et al. 2001, Chen et al. 2002, Aktories and Barbieri 2005). F-actin restruction is accompanied by the dissociation of occluding, ZO-1 and ZO-2 from lateral tight junctions without affecting adherens junctions. These data indicate that Rho proteins play an important role in tight junction regulation. On the other hand, TscH, which mainly modifies Rac, alter the permeability of intestinal cell monolayers causing a redistribution of E-cadherin whereas tight junctions are not significantly affected (Boehm et al. 2006).
TcdA and B induce apoptosis as a consequence of Rho glucosylation and caspase activation (Nottrott et al. 2007, Gerhard et al. 2008) or possibly cell necrosis (Genth et al. 2008). TcdB and TscH cause apoptosis by targeting mitochondria (Petit et al. 2003, Matarrese et al. 2007). In addition, the inactivation of Rho blocks various cellular functions including exocytosis, endocytosis, activation of lymphocyte, phagocytosis in macrophages, control of NADPH oxidase, activation of phospholipase D, contraction of smooth muscle, activation of the pro-apoptotic RhoB, and transcriptional activation via JNK/or p38 (Just and Gerhard 2004, Gerhard et al. 2005, Huelsenbeck et al. 2007, Popoff and Bouvet 2009). TcdA and B induce a large nflammatory response in the gut. There is massive infiltration of neutrophils, and release of many cytokines (Jefferson et al. 1999). TcdA-caused p38 activation induces the production of IL-8 and IL-1beta, necrosis of monocytes, and inflammation of intestinal mucosa (Popoff and Bouvet 2009). TcsL glycocylates Ras and inhibits the MAP-kinase cascade and PLD regulation. On the other hand, the role of those inhibition on cytotoxicity is still unclear (Schmidt et al. 1998, El Hadj et al. 1999).
3. Characterization of TpeL
3.1. Toxicity of TpeL
TpeL was lethal to mice and toxic to Vero cells (Amimoto et al. 2007). The lethal activity of the purified TpeL in mice was determined as 62 MLD/mg (one was 16 μg) and 91 LD50/mg (one LD50 was 11 μg) by intravenous injection (Amimoto et al. 2007). TpeL showed obvious cytotoxicity in Vero cells, and the specific activity was 6.2 x 105 CU/mg (one CU was 1.6 ng) (Amimoto et al. 2007). Morphological changes induced by TpeL in Vero cells. The cytopathic effect induced by a low dose of TpeL was characterized by the enlargement of cells and appearance of rounded cells. Vero cells treated with a high dose of TpeL initially manifested similar changes to those treated with the low dose, then formed aggregates, and eventually detached from the well surface (Amimoto et al. 2007).
Vero cells were incubated with SLO (100 ng/ml) alone (A) or a combination of TpeL1-525 (10 μg/ml) with SLO (100 ng/ml) (B) at 37 °C for 15 min. Pictures were taken after 120 min of resealing. (C) Vero cells were incubated with various amounts of TpeL1-525 with SLO (100 ng/ml) at 37 °C for 15 min. After 120 min of resealing, pictures of cells were taken and the percentage of rounded cells was determined. Value of three experiments were given a mean ± the standard deviation (SD).
To clarify the biological acitivty of TpeL, we prepared a recombinant glycosyltransferase domain, TpeL1-525 (covering amino acids 1 to 525) because native TpeL is labile and is difficult to purify from the culture supernatant of

Figure 5.
Morphological changes of Vero cells upon treatment with SLO plus TpeL1-525.
3.2. tpeL gene
The gene encoding TpeL revealed the presence an ORF of 4953 bases (Amimoto et al. 2007). The
The
3.3. Glucosylation of small G proteins by TpeL
Rac1 is the only substrate GTPase inactivated by all LCTs. When the cells were treated with TpeL in the presence of SLO, glycosylation of cellular Rac1 was confirmed by Western blotting with the glycosylation-sensitive anti-Rac1 (Mab102) (Genth et al. 2006, Nagahama et al. 2011). TpeL and TcsL (Voth and Ballard 2005) act on Rac1 and the Ras subfamily but not RhoA. Furthermore, the isomeric TcdB from the variant
TpeL uses UDP-Glc and UDP-GlcNAc as sugar donors (Nagahama et al. 2011). All other LCTs use a single UDP-hexose (Belyi and Aktories 2010). The crystal structure provides evidence that two amino acids in the vicinity of the catalytic cleft are responsible for the specificity (Jank et al. 2005). TcdA and B, which both use UDP-Glc, have isoleucine and glutamine in the equivalent positions (Ile-383 and Gln-385 in TcdB), whereas TcnL, which uses UDP-GlcNAc, has serine and alanine residues at the respective positions (Jank et al. 2005). It has been reported that the bulkier side chains of Ile-383 and Gln-385 in TcdB limit the space of the catalytic cleft for the binding of UDP-GlcNAc and the exchange of these side chains with smaller groups changes the cosubstrate specificity from UDP-Glc to UDP-GlcNAc (Jank et al. 2005). TpeL has the smaller side chain Ala-383 and the bulkier side chain Gln-385 at the respective positions (Amimoto et al. 2007). We speculate that Ala-383 and Gln-385 in TpeL may stabilize the binding of UDP-Glc and UDP-GlcNAc and favor the acceptance of UDP-Glc and UDP-GlcNAc as the cosubstrates (Nagahama et al. 2011).
The sequential glycosylation of Rac1 by TpeL followed by TcdB, and vice versa indicates that both toxins share the same acceptor amino acid in Rac1. The acceptor amino acid of TcdB-glycosylated Rac1 has been determined as Thr-35 (Belyi and Aktories 2010). TpeL inactivates Rac1 through the glycosylation of Thr-35 (Nagahama et al. 2011).
TpeL glycosylated Rac1, as well as the Ras subfamily consisting of Ha-Ras, RalA, and Rap1B, but not RhoA and Cdc42 (Fig. 4). Important differences in substrate specificity have been detected among the various LCTs. Whereas TcdA, TcdB, and TcnA modify most RhoA, Rac1, and Cdc42 isoforms, TcsL glucosylates Rac1 but not RhoA or Cdc42 (Voth and Ballard 2005). On the other hand, TcsL also modifies the Ras subfamily, including Ras, Rap, and Ral isoforms (Voth and Ballard 2005). Thus, TpeL modifies similar substrates to TcsL. It was reported that Arg-455, Asp-461, Lys-463, and Glu-472 and residues of helix α17 (e.g., Glu-449) of TcdB are essential for enzyme-RhoA recognition (Jank et al. 2007b). Changing the respective amino acid residues in TcsL to those of TcdB reduced glycosylation of Ras by TcsL (Jank et al. 2007a). Furthermore, the introduction of helix α17 of TcdB into TcsL caused a reduction in the glycosylation of Ras subfamily proteins but permitted the glycosylation of RhoA, indicating that helix α17 is involved in RhoA's recognition by TcdB (Jank et al. 2007b). Glu-449, Lys-463, and Glu-472 in TcdB correspond to Lys, Arg, and Gly residues in TcsL and TpeL. Arg-455 in TcdB corresponds to Lys in TcsL and Gly in TpeL (Amimoto et al. 2007). The difference in those amino acid residues may be involved in recognizing small GTPases by TpeL. Additional residues in LCTs are needed for the recognition of small GTPases.
4. Conclusion
Infection with TpeL-positive
References
- 1.
Aktories K. Barbieri J. T. 2005 Bacterial cytotoxins: targeting eukaryotic switches. Nat Rev Microbiol3 397 410 - 2.
Amimoto K. Noro T. Oishi E. Shimizu M. 2007 A novel toxin homologous to large clostridial cytotoxins found in culture supernatant of Clostridium perfringens type C. Microbiology153 1198 1206 - 3.
Barroso L. A. Moncrief J. S. Lyerly D. M. Wilkins T. D. 1994 Mutagenesis of the Clostridium difficile toxin B gene and effect on cytotoxic activity. Microb Pathog16 297 303 - 4.
Barth H. Pfeifer G. Hofmann F. Maier E. Benz R. Aktories K. 2001 Low pH-induced formation of ion channels by Clostridium difficile Toxin B in target cells. J Biol Chem276 10670 10676 - 5.
Bartlett J. G. Onderdonk A. B. Cisneros R. L. Kasper D. L. 1977 Clindamycin-associated colitis due to a toxin-producing species of Clostridium in hamsters. J Infect Dis136 701 705 - 6.
Belyi Y. Aktories K. 2010 Bacterial toxin and effector glycosyltransferases. Biochim Biophys Acta1800 134 143 - 7.
Brito G. A. J. Fujji B. A. Carneiro-Filho A. A. Lima T. Obrig Guerrant R. L. 2002 Mechanism of Clostridium difficile toxin A-induced apoptosis in T84 cells. J Infect Dis186 1438 1447 - 8.
Boehm C. Gibert M. Geny B. Popoff M. R. Rodriguez P. 2006 Modification of epithelial cell barrier permeability and intercellular junctions by Clostridium sordellii lethal toxins. Cell Microbiol8 1070 1085 - 9.
Bosco E. E. Mulloy J. C. Zheng Y. 2009 Rac1 GTPase: a “Rac” of all trades. Cell Mol Life Sci66 370 374 - 10.
Burridge K. Wennerberg K. 2004 Rho and Rac take center stage. Cell116 167 - 11.
Busch C. Aktories K. 2000 Microbial toxins and the glucosylation of Rho family GTPases. Curr Opin Struct Biol10 528 535 - 12.
Busch C. Hofmann F. Gerhard R. Aktories K. 2000a Involvement of a conserved tryptophan residue in the UDP-glucose binding of large clostridial cytotoxin glycosyltransferases. J Biol Chem275 13228 13234 - 13.
Busch C. Schömig K. Hofmann F. Aktories K. 2000b Characterization of the catalytic domain of Clostridium novyi alpha-toxin. Infect Immun68 6378 6383 - 14.
Caron E. Hall A. 1998 Identification of two distinct mechanisms of phagocytosis controlled by different Rho GTPases. Science282 1717 1721 - 15.
Chen M. L. Pothoulakis C. La Mont J. T. 2002 Protein kinase C signaling regulates ZO-1 translocation and increased paracellular flux of T84 colonocytes exposed to Clostridium difficile toxin A. J Biol Chem277 4247 4254 - 16.
Coursodon C. F. Glock R. D. Moore K. L. Cooper K. K. Songer J. G. 2012 TpeL-producing strains of Clostridium perfringens type A are highly virulent for broiler chicks. Anaerobe18 117 121 - 17.
Duffy L. K. Mc Donel J. L. Mc Clane B. A. Kurosky A. 1982 Clostridium perfringens type A enterotoxin: characterization of the amino-terminal region. Infect Immun38 386 388 - 18.
Egerer M. Giesemann T. Jank T. Satchell K. J. Aktories K. 2007 Auto-catalytic cleavage of Clostridium difficile toxins A and B depends on cysteine protease activity. J Biol Chem282 25314 25321 - 19.
Egerer M. Giesemann T. Herrmann C. Aktories K. 2009 Autocatalytic processing of Clostridium difficile toxin B. Binding of inositol hexakisphosphate. J Biol Chem284 3389 3395 - 20.
El Hadj N. B. Popoff M. R. Marvaud J. C. Payrastre B. Boquet P. Geny B. 1999 G-protein-stimulated phospholipase D activity is inhibited by lethal toxin from Clostridium sordellii in HL-60 cells. J Biol Chem274 14021 14031 - 21.
Etienne-Manneville S. Hall A. 2002 Rho GTPases in cell biology. Nature420 629 - 22.
Gao Z. Mc Clane B. A. 2012 Use of Clostridium perfringens Enterotoxin and the Enterotoxin Receptor-Binding Domain (C-CPE) for Cancer Treatment: Opportunities and Challenges. J Toxicol 2012: 981626. - 23.
Genth H. Huelsenbeck J. Hartmann B. Hofmann F. Just I. Gerhard R. 2006 Cellular stability of Rho-GTPases glucosylated by Clostridium difficile toxin B. FEBS Lett580 3565 3569 - 24.
Genth H. Dreger S. C. Huelsenbeck J. Just I. 2008 Clostridium difficile toxins: more than mere inhibitors of Rho proteins. Int J Biochem Cell Biol40 592 597 - 25.
Gerhard R. Tatge H. Genth H. Thum T. Borlak J. Fritz G. Just I. 2005 Clostridium difficile toxin A induces expression of the stress-induced early gene product RhoB. J Biol Chem280 1499 1505 - 26.
Gerhard R. Nottrott S. Schoentaube J. Tatge H. Olling A. Just I. 2008 Glucosylation of Rho GTPases by Clostridium difficile toxin A triggers apoptosis in intestinal epithelial cells. J Med Microbiol57 765 770 - 27.
Geyer M. Wilde C. Selzer J. Aktories K. Kalbitzer H. R. 2003 Glucosylation of Ras by Clostridium sordellii lethal toxin: consequences for the effector loop conformations observed by NMR spectroscopy. Biochemistry42 11951 1195 - 28.
Gibert M. Jolivet-Reynaud C. Popoff M. R. 1997 Beta2-toxin, a novel toxin produced by Clostridium perfringens. Gene203 65 73 - 29.
Giesemann T. Jank T. Gerhard R. Maier E. Just I. Benz R. Aktories K. 2006 Cholesterol-dependent pore formation of Clostridium difficile toxin A. J Biol Chem281 10808 10815 - 30.
Giesemann T. Egerer M. Jank T. Aktories K. 2008 Processing of Clostridium difficile toxins. J Med Microbiol57 690 696 - 31.
Greco A. Ho J. G. Lin S. J. Palcic M. M. Rupnik M. Ng K. K. 2006 Carbohydrate recognition by Clostridium difficile toxin A. Nat Struct Mol Biol13 460 461 - 32.
Gurjar A. Li J. Mc Clane B. A. 2010 Characterization of toxin plasmids in Clostridium perfringens type C isolates. Infect Immun78 4860 4869 - 33.
Halabi-Cabezon I. Huelsenbeck J. May M. Ladwein M. Rottner K. Just I. Genth H. 2008 Prevention of the cytopathic effect induced by Clostridium difficile Toxin B by active Rac1. FEBS Lett582 3751 3756 - 34.
von Eichel-Streiber and N. Suttorp. (Hippenstiel S. Tannert-Otto S. Vollrath N. Krüll M. Just I. Aktories K. C. 1997 Glucosylation of small GTP-binding Rho proteins disrupts endothelial barrier function. Am J Physiol Lung Cell Mol Physiol 272: L38 L43. - 35.
Ho C. S. Bhatnagar J. Cohen A. L. Hacker J. K. Zane S. B. Reagan S. Fischer M. Shieh W. J. Guarner J. Ahmad S. Zaki S. R. Mc Donald L. C. 2009 Undiagnosed cases of fatal Clostridium-associated toxic shock in Californian women of childbearing age. Am J Obstet Gynecol 201: 459.e1 7 - 36.
Ho J. G. Greco A. Rupnik M. Ng K. K. 2005 Crystal structure of receptor-binding C-terminal repeats from Clostridium difficile toxin A. Proc Natl Acad Sci USA102 18373 18378 - 37.
Huelsenbeck J. Dreger S. C. Gerhard R. Fritz G. Just I. Genth H. 2007 Upregulation of the immediate early gene product RhoB by exoenzyme C3 from Clostridium limosum and toxin B from Clostridium difficile. Biochemistry46 4923 4931 - 38.
Jank T. Reinert D. J. Giesemann T. Schulz G. E. Aktories K. 2005 Change of the donor substrate specificity of Clostridium difficile toxin B by site-directed mutagenesis. J Biol Chem280 37833 37838 - 39.
Jank T. Giesemann T. Aktories K. 2007a Clostridium difficile glucosyltransferase Toxin B-essential amino acids for substrate binding. J Biol. Chem282 35222 35231 - 40.
Jank T. Giesemann T. Aktories K. 2007b Rho-glucosylating Clostridium difficile Toxins A and B: new insights into structure and function. Glycobiology 17: 15R-22R. - 41.
Jefferson K. K. Smith M. F. Jr Bobak D. A. 1999 Roles of intracellular calcium and NF-kappa B in the Clostridium difficile toxin A-induced up-regulation and secretion of IL-8 from human monocytes. J Immunol163 5183 5191 - 42.
Jolivet-Reynaud C. Cavaillon J. M. Alouf J. E. 1982 Selective cytotoxicity of Clostridium perfringens delta toxin on rabbit leukocytes. Infect Immun38 860 - 43.
Just I. Hofmann F. Aktories K. 2000 Molecular mechanism of action of the large clostridial cytotoxins, in Bacterial Protein Toxins. K. Aktories and I. Just, Editors. Springer, Berlin,307 331 - 44.
Just I. Gerhard R. 2004 Large clostridial cytotoxins. Rev Physiol Biochem Pharmacol152 23 47 - 45.
Karlsson K. A. 1995 Microbial recognition of target-cell glycoconjugates. Curr Opin Struc Bio5 622 635 - 46.
Katayama S. Dupuy B. Daube G. China B. Cole S. T. 1996 Genome mapping of Clostridium perfringens strains with I-CeuI shows many virulence genes to be plasmid-borne. Mol Gen Genet251 720 726 - 47.
Kelly C. P. La Mont J. T. 2008 Clostridium difficile- more difficult than ever. N Engl J Med359 1932 1940 - 48.
Kreimeyer I. Euler F. Marckscheffel A. Tatge H. Pich A. Olling A. Schwarz J. Just I. Gerhard R. 2011 Autoproteolytic cleavage mediates cytotoxicity of Clostridium difficile Toxin A. Naunyn Schmiedebergs Arch Pharmacol383 253 262 - 49.
Manteca C. Daube G. Jauniaux T. Linden A. Pirson V. Detilleux J. Ginter A. Coppe P. Kaeckenbeeck A. Mainil J. G. 2002 A role for the Clostridium perfringens beta2 toxin in bovine enterotoxaemia? Vet Microbiol86 191 202 - 50.
Matarrese P. Falzano L. Fabbri A. Gambardella L. Frank C. Geny B. Popoff M. R. Malorni W. Fiorentini C. 2007 Clostridium difficile toxin B causes apoptosis in epithelial cells by thrilling mitochondria. Involvement of ATP-sensitive mitochondrial potassium channels. J Biol Chem282 9029 9041 - 51.
Mesmin B. Robbe K. Geny B. Luton F. Brandolin G. Popoff M. R. Antonny B. 2004 A phosphatidylserine-binding site in the cytosolic fragment of Clostridium sordellii lethal toxin facilitates glucosylation of membrane-bound Rac and is required for cytotoxicity. J Biol Chem279 49876 49882 - 52.
von Eichel-Streiber and M. Moos. (Müller S. C. 1999 Impact of amino acids 22-27 of Rho-subfamily GTPases on glucosylation by the large clostridial cytotoxins TcsL-1522, TcdB-1470 and TcdB-8864. Eur J Biochem266 1073 1080 - 53.
Na X. H. Kim M. P. Moyer C. Pothoulakis La Mont J. T. 2008 gp96 is a human colonocyte plasma membrane binding protein for Clostridium difficile toxin A. Infect Immun76 2862 2871 - 54.
Nagahama M. Hayashi S. Morimitsu S. Sakurai J. 2003 Biological activities and pore formation of Clostridium perfringens beta toxin in HL 60 cells. J Biol Chem278 36934 36941 - 55.
Nagahama M. Ohkubo A. Oda M. Kobayashi K. Amimoto K. Miyamoto K. Sakurai J. 2011 Clostridium perfringens TpeL glycosylates the Rac and Ras subfamily proteins. Infect Immun79 905 910 - 56.
Naylor C. E. Eaton J. T. Howells A. Justin N. Moss D. S. Titball R. W. Basak A. K. 1998 Structure of the key toxin in gas gangrene. Nat Struc. Biol5 738 746 - 57.
Nottrott S. Schoentaube J. Genth H. Just J. Gerhard R. 2007 Clostridium difficile toxin A-induced apoptosis is53 but depends on glucosylation of Rho GTPases. Apoptosis 12: 1443-1453. - 58.
Nusrat A. von C. Eichel-Streiber C. J. R. Turner P. Verkade J. L. Madara Parkos C. A. 2001 Clostridium difficile toxins disrupt epithelial barrier function by altering membrane microdomain localization of tight junction proteins. Infect Immun69 1329 1336 - 59.
Ochi S. Miyawaki T. Matsuda H. Oda M. Nagahama M. Sakurai J. 2002 Clostridium perfringens alpha-toxin induces rabbit neutrophil adhesion. Microbiology148 237 - 60.
Oda M. Ikari S. Matsuno T. Morimune Y. Nagahama M. Sakurai J. 2006 Signal transduction mechanism involved in Clostridium perfringens alpha-toxin-induced superoxide anion generation in rabbit neutrophils. Infect Immun74 2876 - 61.
Ottlinger M. E. Lin S. 1988 Clostridium difficile toxin B induces reorganization of actin, vinculin, and talin in cultured cells. Exp Cell Res174 215 229 - 62.
Paredes-Sabja D. Sarker N. Sarker M. R. 2011 Clostridium perfringens tpeL is expressed during sporulation. Microb Pathog51 384 388 - 63.
Petit P. Bréard J. Montalescot V. El Hadj N. B. Levade T. Popoff M. Geny B. 2003 Lethal toxin from Clostridium sordellii induces apoptotic cell death by disruption of mitochondrial homeostasis in HL-60 cells. Cell Microbiol5 761 771 - 64.
Pfeifer G. Schirmer J. Leemhuis J. Busch C. Meyer D. K. Aktories K. Barth H. 2003 Cellular uptake of Clostridium difficile toxin B: translocation of the N-terminal catalytic domain into the cytosol of eukaryotic cells. J Biol Chem278 44535 44541 - 65.
de Gunzburg and P. Boquet. (Popoff M. R. Chaves-Olarte F. Femichez E. von C. Eichel-Streiber M. Thelestam P. Chardin D. Cussac B. Antonny P. Chavrier G. Flatau M. Giry J. 1996 Ras, Rap, and Rac small GTP-binding proteins are targets for Clostridium sordellii lethal toxin glucosylation. J Biol Chem271 10217 10224 - 66.
Popoff M. R. Bouvet P. 2009 Clostridial toxins. Future Microbiol4 1021 1064 - 67.
von Eichel-Streiber and K. Aktories. (Prepens U. Just I. C. 1996 Inhibition of Fc epsilon-RI-mediated activation of rat basophilic leukemia cells by Clostridium difficile toxin B (monoglucosyltransferase). J Biol Chem271 7324 7329 - 68.
Pruitt R. N. Chagot B. Cover M. Chazin W. J. Spiller B. Lacy D. B. 2009 Structure-function analysis of inositol hexakisphosphate-induced autoprocessing in Clostridium difficile Toxin A. J Biol Chem284 21934 21940 - 69.
Qa’Dan M. Spyres L. M. Ballard J. D. 2000 pH-induced conformational changes in Clostridium difficile Toxin B. Infect Immun68 2470 2474 - 70.
Qa’Dan M. Spyres L. M. Ballard J. D. 2001 pH-enhanced cytopathic effects of Clostridium sordellii lethal toxin. Infect Immun69 5487 5493 - 71.
Reineke J. Tenzer S. Rupnik M. Koschinski A. Hasselmayer O. Schrattenholz A. Schild H. von C. Eichel-Streiber 2007 Autocatalytic cleavage of Clostridium difficile toxin B. Nature446 415 419 - 72.
Reinert D. J. Jank T. Aktories K. Schulz G. E. 2005 Structural basis for the function of Clostridium difficile toxin B. J Mol Biol351 973 981 - 73.
Rupnik M. Pabst S. Rupnik M. von C. Eichel-Streiber H. Urlaub Soling H. D. 2005 Characterization of the cleavage site and function of resulting cleavage fragments after limited proteolysis of Clostridium difficile toxin B (TcdB) by host cells. Microbiology151 199 208 - 74.
Sakurai J. Nagahama M. Ochi S. 1997 Major toxins of Clostridium perfringens. J Toxicol Toxin Rev16 195 214 - 75.
Sakurai J. Nagahama M. Oda M. 2004 Clostridium perfringens alpha-toxin: characterization and mode of action. J Biochem136 569 574 - 76.
Sakurai J. Nagahama M. 2006 Clostridium perfringens beta-toxin: characterization and action. Toxin Rev25 89 108 - 77.
Sandvig K. Spilsberg B. Lauvrak S. U. Torgersen M. L. Iversen T. G. van Deurs B. 2004 Pathways followed by protein toxins into cells. Int J Med Microbiol293 483 - 78.
Sayeed S. Li J. Mc Clane B. A. 2010 Characterization of virulence plasmid diversity among Clostridium perfringens type B isolates. Infect Immun78 495 504 - 79.
von Eichel-Streiber and K. H. Jakobs. (Schmidt M. Rümenapp U. Bienek C. Keller J. C. 1996 Inhibition of receptor signaling to phospholipase D by Clostridium difficile toxin B. Role of Rho proteins. J Biol Chem271 2422 2426 - 80.
Schmidt M. Voss M. Thiel M. Bauer B. Grannass A. Tapp E. Cool R. H. de Gunzburg J. von C. Eichel-Streiber Jakobs K. H. 1998 Specific inhibition of phorbol ester-stimulated phospholipase D by Clostridium sordellii lethal toxin and Clostridium difficile toxin B-1470 in HEK-293 cells. J Biol Chem273 7413 7422 - 81.
Sehr P. Joseph G. Genth H. Just I. Pick E. Aktories K. 1998 Glucosylation and ADP-ribosylation of Rho proteins- Effects on nucleotide binding, GTPase activity, and effector-coupling. Biochemistry37 5296 5304 - 82.
Selzer J. Hofmann F. Rex G. Wilm M. Mann M. Just I. Aktories K. 1996 Clostridium novyi α-toxin-catalyzed incorporation of GlcNAc into Rho subfamily proteins. J Biol Chem271 25173 25177 - 83.
Servant G. Weiner O. D. Herzmark P. Balla T. Sedat J. W. Bourne H. R. 2000 Polarization of chemoattractant receptor signaling during neutrophil chemotaxis. Science287 1037 1040 - 84.
Shimizu T. Ohtani K. Hirakawa H. Ohshima K. Yamashita A. Shiba T. Ogasawara N. Hattori M. Kuhara S. Hayashi H. 2002 Complete genome sequence of Clostridium perfringens, an anaerobic flesh-eater. Proc Natl Acad Sci USA99 996 1001 - 85.
Singh U. Mitic L. L. Wieckowski E. U. Anderson J. M. Mc Clane B. A. 2001 Comparative biochemical and immunocytochemical studies reveal differences in the effects of Clostridium perfringens enterotoxin on polarized CaCo-2 cells versus Vero cells. J Biol Chem276 33402 33412 - 86.
Tsokos M. S. Schalinski F. Paulsen J. P. Sperhake K. Puschel Sobottka I. 2008 Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases. Int J Legal Med122 35 41 - 87.
Tweten R. K. 2005 Cholesterol-dependent cytolysins, a family of versatile pore-forming toxins. Infect Immun73 6199 6209 - 88.
Vetter I. R. Hofmann F. Wohlgemuth S. Herrmann C. Just I. 2000 Structural consequences of mono-glucosylation of Ha-Ras by Clostridium sordellii lethal toxin. J Mol Biol301 1091 1095 - 89.
von-Streiber Eichel. C. Sauerborn M. Kuramitsu H. K. 1992 Evidence for a modular structure of the homologous repetitive C-terminal carbohydrate-binding sites of Clostridium difficile toxins and Streptococcus mutans glucosyltransferases. J Bacteriol174 6707 6710 - 90.
Voth D. E. Ballard J. D. 2005 Clostridium difficile toxins: mechanism of action and role in disease. Clin Microbiol Rev18 247 263 - 91.
Waters M. Savoie A. Garmory H. S. Bueschel D. Popoff M. R. Songer J. G. Titball R. W. Mc Clane B. A. Sarker M. R. 2003 Genotyping and phenotyping of beta2-toxigenic Clostridium perfringens fecal isolates associated with gastrointestinal diseases in piglets. J Clin Microbiol41 3584 3591 - 92.
Ziegler M. O. Jank T. Aktories K. Schulz G. E. 2008 Conformational changes and reaction of clostridial glycosylating toxins. J Mol Biol377 1346 1356