EEF2 and diphtheria: The best characterized mono-ADP-ribosylation reactions are those catalyzed by bacterial toxins, such as diphtheria, cholera, pertussis and clostridial toxins, which act by modifying crucial host cell proteins such as the α-subunit of heterotrimeric GTP-binding (G) proteins, the small GTPase Rho, monomeric actin and elongation factor 2 (EF-2), resulting in permanent activation or inactivation of the cell functions modulated by these protein substrates.