text: Bacterial ADP-ribosylating exotoxins (bAREs) covalently transfer an ADP-ribose moiety of NAD to target proteins of infected eukaryotes, to yield nicotinamide and a free hydrogen ion. bAREs are produced as enzyme precursors, consisting of a "A" and "B" domains: the "A" domain is responsible for ADP-ribosylation activity; and, the "B" domain for translocation of the enzyme across the membrane of the cell. These domains can exist in concert in three forms: first, as single polypeptide chains with A and B domains covalently linked; second, in multi-protein complexes with A and B domains bound by non-covalent interactions; and, third, in multi-protein complexes with A and B domains not directly interacting, prior to processing.
  Upon activation, bAREs ADP-ribosylate any number of eukaryotic proteins; such mechanism is crucial to the instigation of the diseased states associated with ADP-ribosylation.  GTP-binding proteins, in particular, are well-established in bAREs pathophysiology.  For examples, cholera and heat-labile enterotoxin target the α-subunit of Gs of heterotrimeric GTP-binding proteins. As the α-subunit is ADP-ribosylated, it is permanently in an "active", GTP-bound state; subsequent activation of intracellular cyclic AMP stimulates the release of fluid and ions from intestinal epithelial cells. Furthermore, C. Botulinum C3 ADP-ribosylates GTP-binding proteins Rho and Ras, and Pertussis toxin ADP-ribosylates Gi, Go, and Gt. Diphtheria toxin ADP-ribosylates ribosomal elongation factor EF-2, which attenuates protein synthesis.
  There are a variety of bacteria which employ bAREs in infection: CARDS toxin of Mycoplasma pneumoniae, cholera toxin of Vibrio cholerae; heat-labile enterotoxin of E. coli; exotoxin A of Pseudomonas aeruginosa; pertussis toxin of B. pertussis; C3 toxin of C. botulinum; and diphtheria toxin of Corynebacterium diphtheriae.