The innate immune system in humans consists of both cellular and humoral components that collaborate to eradicate invading bacteria from the body. Here, we discover that the Gram-positive bacterium Bacillus anthracis, the causative agent of anthrax, does not grow in human serum. Fractionation of serum by gel filtration chromatography led to the identification of human transferrin as the inhibiting factor. Purified transferrin blocks growth of both the fully virulent encapsulated B. anthracis Ames and the non-encapsulated Sterne strain. Growth inhibition was also observed in serum of wild-type mice but not of hypotransferrinemic mice that only have ϳ1% circulating transferrin levels. We were able to definitely assign the bacteriostatic activity of transferrin to its iron-binding function: neither iron-saturated transferrin nor a recombinant transferrin mutant unable to bind iron could inhibit growth of B. anthracis. Additional iron could restore bacterial growth in human serum. The observation that other important Gram-positive pathogens are not inhibited by transferrin suggests they have evolved effective mechanisms to circumvent serum iron deprivation. These findings provide a better understanding of human host defense mechanisms against anthrax and provide a mechanistic basis for the antimicrobial activity of human transferrin.The Gram-positive bacterium Bacillus anthracis can infect humans and is notorious for its potential as a biological weapon (1). Depending on the route of infection, B. anthracis causes respiratory, cutaneous, or gastrointestinal anthrax (2). The most lethal form, respiratory anthrax, is caused by inhalation of dormant bacterial spores, which are taken up by alveolar macrophages and dendritic cells. These spores can germinate within macrophages and hijack them for transport of vegetative bacilli to the lymph nodes. Subsequent spread into the bloodstream often results in sepsis and death (1). The ability to divide within macrophages without inducing an inflammatory reaction depends on the plasmid-encoded tripartite anthrax toxin (pXO1) that blocks intracellular signaling in immune cells (3-5). Intradermal inoculation with B. anthracis spores results in cutaneous anthrax, a milder infection that normally remains localized and resolves spontaneously (6).Little is known about human innate immune defenses against B. anthracis (7). In cutaneous anthrax, neutrophils are essential for maintaining a localized infection (6). Recent studies have demonstrated that cathelicidin antimicrobial peptides, expressed by epithelial cells and phagocytes, are also an important component the innate immune response that targets B. anthracis (8 -9). Serum proteins provide additional defense functions by activation of the complement system. Complement-depleted or C5-deficient mice are much more susceptible to infection with B. anthracis (10). However, the poly-␥-D glutamic acid capsule (pXO2) makes B. anthracis highly resistant to complement-dependent clearance (11). Here we discover that serum also provides resis...