Cytolethal distending toxin (CDT) is a newly identified virulence factor produced by several pathogenic bacteria implicated in chronic infection. Seventy three strains of periodontopathogenic bacteria were examined for the production of CDT by a HeLa cell bioassay and for the presence of the cdt gene by PCR with degenerative oligonucleotide primers, which were designed based on various regions of the Escherichia coli and Campylobacter cdtB genes, which have been successfully used for the identification and cloning of cdtABC genes from Actinobacillus actinomycetemcomitans Y4 (M. Sugai et al., Infect. Immun. 66:5008-5019, 1998). CDT activity was found in culture supernatants of 40 of 45 tested A. actinomycetemcomintans strains, but the titer of the toxin varied considerably among these strains. PCR experiments indicated the presence of Y4-type cdt sequences in these strains, but the rest of A. actinomycetemcomitans were negative by PCR amplification and also by Southern blot analysis for the cdtABC gene. In the 40 CDT-positive strains, Southern hybridization with HindIII-digested genomic DNA revealed that there are at least 6 restriction fragment length polymorphism types. This suggests that the cdtABC flanking region is highly polymorphic, which may partly explain the variability of the CDT activity in the culture supernatants. The rest of tested strains of periodontopathogenic bacteria did not have detectable CDT production by the HeLa cell assay and for cdtB sequences by PCR analysis under our experimental conditions. These results strongly suggested that CDT is a unique toxin predominantly produced by A. actinomycetemcomitans among periodontopathogenic bacteria.Periodontitis is a destructive inflammatory response affecting the tooth-supporting tissues. Etiological and microbiological studies have well established that dental plaque, a composite of microorganisms and their products, plays a major role in the pathogenesis of periodontitis (2, 34). Previous evidence suggests that it participates in promoting inflammation of gingival tissue through direct cytotoxicity and indirect immunemediated responses (33). A variety of bacterial products in dental plaque have been implicated in this process. Actinobacillus actinomycetemcomitans has been suspected to be one of the key pathogens in the etiology of human periodontitis (30,34). It produces a variety of virulence factors including cytotoxic factors (2, 8-12, 17, 19, 28, 31), chemotactic inhibitors (33), collagenases (24), and lipopolysaccharides (13, 25). Among the cytotoxic factors, leukotoxin has been the most extensively studied (14-16, 18). Recently, we and others discovered another cytotoxic factor which shows cell cycle-specific growth inhibitory activity as a new member of the cytolethal distending toxin (CDT) family in A. actinomycetemcomitans Y4 (18, 28, 32). The CDTs are produced by a variety of bacterial genera and form a heterogeneous family of toxins with similar biological activities (4,20,23,26). The term CDT was designated for an activity that ind...