Protective antigen (PA) is the cell surface recognition unit of the binary anthrax toxin system and the primary immunogenic component in both the current and proposed "next-generation" anthrax vaccines. Several studies utilizing animal models have indicated that PA-specific antibodies, acquired by either active or passive immunization, are sufficient to protect against infection with Bacillus anthracis. To investigate the human antibody response to anthrax immunization, we have established a large panel of human PA-specific monoclonal antibodies derived from multiple individuals vaccinated with the currently approved anthrax vaccine BioThrax. We have determined that although these antibodies bind PA in standard binding assays such as enzyme-linked immunosorbent assay, Western blotting, capture assays, and dot blots, less than 25% are capable of neutralizing lethal toxin (LT) in vitro. Nonneutralizing antibodies also fail to neutralize toxin when present in combination with other nonneutralizing paratopes. Although neutralizing antibodies recognize determinants throughout the PA monomer, they are significantly less common among those paratopes that bind to the immunodominant amino-terminal portion of the molecule. These findings demonstrate that PA binding alone is not sufficient to neutralize LT and suggest that for an antibody to effectively block PA-mediated toxicity, it must bind to PA such that one of the requisite toxin functions is disrupted. A vaccine design strategy that directed a higher percentage of the antibody response toward neutralizing epitopes may result in a more efficacious vaccine for the prevention of anthrax infection.The Bacillus anthracis binary toxin system contributes directly to anthrax pathogenicity in the host (3,14). The cell surface recognition element of this toxin system is an 83-kDa protein known as protective antigen (PA 83 ). Antibodies that bind PA protect against infection (8, 12), and PA is the primary immunogenic component in the anthrax vaccine currently licensed for use in the United States (BioThrax, or anthrax vaccine adsorbed [AVA]; Emergent Biosystems). Ongoing attempts to develop a "next-generation" anthrax vaccine are relying on a recombinant form of PA as the sole immunogenic component. PA's role as an important vaccine target has driven a significant amount of research into both the biology of this protein toxin and the immunobiology of its interaction with the immune system of the vaccinated or infected host.PA 83 binds to the cell surface receptors tumor endothelial marker 8 and the capillary morphogenesis gene 2 product (4, 20). Bound PA is cleaved by cell surface-associated furin proteases to release the 20-kDa amino-terminal portion of the molecule (PA 20 ), which has no further role in intoxication. Following proteolytic cleavage, cell-bound PA 63 self-assembles to form a heptameric prepore structure that can bind several molecules of the catalytic toxin components lethal factor (LF) and/or edema factor (EF). Receptor-mediated endocytosis results in the int...