The production of cholera toxin (CT) during Vibrio cholerae infection results in the hallmark diarrhea that characterizes the disease cholera. The transmembrane protein ToxR was originally identified as a functional transcriptional activator of ctxAB in a heterologous Escherichia coli system. However, direct ToxR activation of the ctxAB promoter in V. cholerae has not been previously demonstrated. Instead, a regulatory cascade has been defined in which the activators ToxRS and TcpPH modulate ctxAB expression by acting in concert to transcriptionally activate another regulator, ToxT. ToxT, in turn, directly activates ctxAB expression as well as expression of the tcp genes and other virulence-associated genes. In this study, we show that ToxRS directly activates ctxAB in a ToxT-independent manner in a classical biotype V. cholerae, and that this activation requires the presence of bile acids. Although the levels of CT induced by this mechanism are lower than levels induced under other in vitro conditions, the bile-dependent conditions described here are more physiologic, being independent of pH and temperature. We further show that the inability of bile acids to stimulate ToxRS-dependent expression of CT in El Tor biotype strains is related to the differences between classical and El Tor ctxAB promoters, which differ in the number of heptad TTTTGAT repeats in their respective upstream regions. The ability of bile acids to stimulate direct activation of ctxAB by ToxRS depends upon the transmembrane domain of ToxR, which may interact with bile acids in the inner membrane of V. cholerae.
The Gram-negative bacterium Vibrio cholerae is the infectious agent that causes the severe human diarrheal disease cholera (1). Two major virulence factors, cholera toxin (CT) and the toxin-coregulated pilus (TCP), play major roles in the pathogenesis of this infection. Secretion of CT, an ADP-ribosylating toxin encoded in the genome of the filamentous, lysogenic CTX⌽ phage, results in elevated cAMP levels in intestinal epithelial cells and subsequent secretory diarrhea (2). The regulation of CT and TCP expression has been studied intensely and has been reported to respond to temperature, pH, osmolarity, bile salts, and certain amino acids in vitro (3, 4); nevertheless, a clear understanding of the in vivo environmental stimuli that trigger CT and TCP production remains elusive.The first transcriptional regulator of CT production identified was ToxR, a 32-kDa inner-membrane protein that activates the ctx promoter in Escherichia coli and whose deletion in V. cholerae results in the inability to produce CT (5). Deletion analysis of the ctxAB promoter localized the binding site of ToxR to multiple heptad repeats, TTTTGAT, upstream of ctxAB (6). However, ToxR activation of ctxAB transcription in V. cholerae has not been demonstrated (7). Instead, ToxR in V. cholerae binds with its downstream enhancer ToxS to the upstream region of the toxT gene, which encodes another transcriptional activator (8). ToxT belongs to the AraC family of trans...