Alpha-toxin has been shown to play a role in pathogenesis of disease, as hly knockout strains show reductions in invasiveness and virulence. The dosage of toxin can result in two different modes of activity. Low concentrations of toxin bind to specific, but unidentified, cell surface receptors and form the heptameric pores. This pore allows the exchange of monovalent ions, resulting in DNA fragmentation and eventually apoptosis. Higher concentrations result in the toxin absorbing nonspecifically to the lipid bilayer and forming large, Ca2+ permissive pores. This in turn results in massive necrosis and other secondary cellular reactions triggered by the uncontrolled Ca2+ influx.
