Cholera toxin (CT) is an AB(5) hexameric protein responsible for the s
ymptoms produced by Vibrio cholerae infection. In the first step of ce
ll intoxication, the B-pentamer of the toxin binds specifically to the
branched pentasaccharide moiety of ganglioside G(M1) on the surface o
f target human intestinal epithelial cells. We present here the crysta
l structure of the cholera toxin B-pentamer complexed with the G(M1) p
entasaccharide. Each receptor binding site on the toxin is found to li
e primarily within a single B-subunit, with a single solvent-mediated
hydrogen bond from residue Gly 33 of an adjacent subunit. The large ma
jority of interactions between the receptor and the toxin involve the
2 terminal sugars of G(M1), galactose and sialic acid, with a smaller
contribution from the N-acetyl galactosamine residue. The binding of G
(M1) to cholera toxin thus resembles a 2-fingered grip: the Gal(beta 1
-3)GalNAc moiety representing the ''forefinger'' and the sialic acid r
epresenting the ''thumb.'' The residues forming the binding site are c
onserved between cholera toxin and the homologous heat-labile enteroto
xin from Escherichia coli, with the sole exception of His 13. Some rep
orted differences in the binding affinity of the 2 toxins for ganglios
ides other than G(M1) may be rationalized by sequence differences at t
his residue. The CTB5:G(M1) pentasaccharide complex described here pro
vides a detailed view of a protein:ganglioside specific binding intera
ction, and as such is of interest not only for understanding cholera p
athogenesis and for the design of drugs and development of vaccines bu
t also for modeling other protein:ganglioside interactions such as tho
se involved in G(M1)-mediated signal transduction.