toxin encoded on ctxAB operon, RBS is closer to consensus for B than A so 5B:1A, CTA is cleaved (CTA1 is enzymatic), CTA2 binds B and is held together by disulfide bonds, CTB binds GMA1, endocytosis of receptor with toxin, dissociation of CTA, CTA1 has ADP ribosyltransferase activity, targets Gs alpha, CTA1 adds ADP-ribose to GS alpha in GTP bounds form, Gs alpha stays bound to GTP which activates adenylate cyclase and converts ATP to cAMP, ions flow out and so does water