Pertussis toxin accumulates in the periplasm of Bordetella pertussis prior to secretion, and we examined its fate following treatment with antimicrobial agents. Both antibiotics that inhibit protein synthesis (erythromycin and chloramphenicol), transcription (rifampin), or cell wall biosynthesis (cefoperazone and piperacillin) and magnesium sulfate (which inhibits transcription of pertussis toxin, but not bacterial growth) did not prevent release of preformed toxin. In contrast, agents that affect bacterial membranes, such as polymyxin B, lidocaine, procaine, and ethanol, inhibited release of preformed pertussis toxin. These results suggest new protein synthesis is not required for pertussis toxin secretion, but a functional membrane complex is required.Pertussis toxin is a member of the AB 5 family of toxins, which includes cholera toxin, Escherichia coli heat-labile toxin, and Shiga toxin. It is a critical virulence factor for the gramnegative bacterium Bordetella pertussis, the causative agent of whooping cough (21,22,32). It is also the most complex bacterial toxin known, comprised of six subunits, called S1, S2, S3, S4, and S5 in a 1:1:1:2:1 ratio (14,17,27). S1 is the A component of pertussis toxin, the part of the toxin that mediates damage to host cells. S1 enzymatically attaches the ADP-ribose group from NAD onto mammalian GTP binding proteins, abolishing normal cellular regulation. S2 to S5 associate to form the B component, or B pentamer, which binds to the host cell and delivers S1 into the cytoplasm of target cells.This complex structure of pertussis toxin seems to necessitate an equally complex pathway for assembly and secretion from the bacterium. Each of the toxin subunits is synthesized with an N-terminal signal sequence, which mediates secretion to the periplasm, where the signal peptide is removed and the subunits fold and assemble into holotoxin (17). Finally, secretion of the assembled toxin past the outer membrane is mediated by the proteins encoded by the ptl operon (PtlA through PtlI) (7, 33). Interestingly, AB 5 toxins have only been found in gram-negative bacteria. A possible explanation is that without the compartment provided by the periplasm of the gram-negative bacterium, the six toxin subunits would be unable to efficiently associate and assemble. Gram-positive bacteria lack this compartment and might release predominantly nonfunctional (and possibly immunizing) subunits.While the periplasm may be needed for efficient assembly of the AB 5 toxins, it can still act as a barrier to toxin secretion, and strains producing AB 5 toxins tend to accumulate intracellular pools of toxin. A dose as small as 0.05 to 0.15 ng of pertussis toxin per ml can elicit a positive response in the Chinese hamster ovary (CHO) cell assay (9, 33), and we have observed that B. pertussis accumulates hundreds of nanograms of periplasmic pertussis toxin, a potentially significant dose.We were interested in examining what happened to this pool of toxin during antibiotic treatment.In some situations, antibiotic tr...