Lipopolysaccharide (LPS) activates the innate immune response through the Toll-like receptor 4 (TLR4)⅐MD-2 complex. A synthetic lipid A precursor, lipid IV A , induces an innate immune response in mice but not in humans. Both TLR4 and MD-2 are required for the agonist activity of lipid IV A in mice, with TLR4 interacting through specific surface charges at the dimerization interface. In this study, we used site-directed mutagenesis to identify the MD-2 residues that determine lipid IV A species specificity. A single mutation of murine MD-2 at the hydrophobic pocket entrance, E122K, substantially reduced the response to lipid IV A . Combining the murine MD-2 E122K with the murine TLR4 K367E/S386K/R434Q mutations completely abolished the response to lipid IV A , effectively converting the murine cellular response to a human-like response. In human cells, however, simultaneous mutations of K122E, K125L, Y41F, and R69G on human MD-2 were required to promote a response to lipid IV A . Combining the human MD-2 quadruple mutations with the human TLR4 E369K/Q436R mutations completely converted the human MD-2/human TLR4 receptor to a murinelike receptor. Because MD-2 residues 122 and 125 reside at the dimerization interface near the pocket entrance, surface charge differences here directly affect receptor dimerization. In comparison, residues 42 and 69 reside at the MD-2/TLR4 interaction surface opposite the dimerization interface. Surface charge differences there likely affect the binding angle and/or rigidity between MD-2 and TLR4, exerting an indirect influence on receptor dimerization and activation. Thus, surface charge differences at the two MD-2/TLR4 interfaces determine the species-specific activation of lipid IV A .Lipopolysaccharide (LPS), also known as endotoxin, activates the innate immune response during Gram-negative bacterial infection. Lipid A, the active component of LPS, anchors LPS to the outer leaflet of the outer membrane of Gram-negative bacteria. When bacteria divide or die, LPS released into local tissue or the circulation can trigger innate immune recognition (1). Lipid A from most species is highly proinflammatory, although certain lipid A molecules and precursors lack stimulatory power. The synthetic precursor of Escherichia coli lipid A, tetraacylated lipid IV A (2) (compound 406), is an agonist in murine cells and a partial agonist in equine cells but is an antagonist in human cells (3).The Toll-like receptor 4 (TLR4) 2 and MD-2 complex constitute the essential components of a receptor system for LPS (4, 5). CD14, initially believed to be the LPS receptor, is an enhancing component of the LPS receptor (6). The lack of a transmembrane or an intracellular signaling domain led to speculation about an additional LPS receptor component that actually transduces the LPS signal. TLR4 was identified as the signaling component of the LPS receptor, based on positional cloning in mice that fail to respond to LPS (4, 7) and on the finding that TLR4 knock-out cells did not respond to LPS (8). The co-recept...