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It is a cell-penetrating myotoxin that enters tumor cells by binding to cell surface heparan sulfate proteoglycans (HSPGs), triggering its endocytosis (103)

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Malfunctioning phagocytosis impairs the killing of bacteria that reach the lamina propria through the permeable epithelial barrier, which results in excessive Toll-like receptor stimulation, proinflammatory cytokine secretions, and activation of acquired immune responses, all of which significantly raise intestinal inflammatory reactions in genetically susceptible individuals who harbor mutations in the IBD-susceptibility gene(s) (Duboc et al., 2013)