Immunotoxins kill target cells mainly by:
Mechanism by which protein toxins arrest protein synthesis culminates in rapid programmed cell death via mitochondrial pathway capable of killing quiescent cells. Diphtheria toxin fragment A catalyzes ADP-ribosylation of unusual post-translationally modified histidine diphthamide at position 699 of eukaryotic elongation factor 2 present exclusively on domain IV, using oxidized NAD+ as ADP-ribose donor releasing nicotinamide. Modified elongation factor cannot mediate translocation step of peptidyl-tRNA from A site to P site on 60S ribosomal subunit, halting elongation after single round. Ricin A chain functions as RNA N-glycosidase hydrolyzing N-glycosidic bond of adenine 4324 in 28S ribosomal RNA alpha sarcin-ricin loop critical for EF2 GTPase activation, depurinating single base rendering 60S subunit unable to bind elongation factors. Both events cause accumulation of stalled ribosomes triggering ribotoxic stress response via MAP3K ZAK activating JNK and p38, plus depletion of short-lived anti-apoptotic proteins Mcl-1 half-life thirty minutes, XIAP, c-FLIP required to restrain caspase cascade, tipping balance toward Bax Bak oligomerization forming mitochondrial outer membrane pores releasing cytochrome c, Smac DIABLO, formation of Apaf-1 apoptosome activating initiator caspase 9 then executioners caspase 3 and 7 cleaving PARP leading to chromatin condensation within hours even in nondividing cells resistant to mitotic inhibitors.
Ref: Collier Annu Rev Biochem 1975 diphtheria ADP-ribosyl EF2; Olsnes Pharmac Ther ribosome N-glycosidase ricin apoptosis.