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However, novel alternatives have emerged in the form of targeted therapies based on AB toxins. These biotoxins are a diverse group of highly poisonous molecules that show a nanomolar affinity for their target cell receptors, making them an invaluable source of ligands for biomedical applications. Bacterial AB toxins, in particular, are modular proteins that can be genetically engineered to develop high-affinity therapeutic compounds. These toxins consist of two distinct domains: a catalytically active domain and an innocuous domain that acts as a ligand, directing the catalytic domain to the target cells. Interestingly, many tumor cells show receptors on the surface that are recognized by AB toxins, making these high-affinity proteins promising tools for developing new methods for targeting anticancer therapies. Here we describe the structure and mechanisms of action of Diphtheria (Dtx), Anthrax (Atx), Shiga (Stx), and Cholera (Ctx) toxins, and review the potential uses of AB toxins in cancer therapy. We also discuss the main advances in this field, some successful results, and, finally, the possible development of innovative and precise applications in oncology based on engineered recombinant AB toxins.<\/jats:p>","DOI":"10.3390\/ijms241311227","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:35:21Z","timestamp":1688949321000},"page":"11227","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["AB Toxins as High-Affinity Ligands for Cell Targeting in Cancer Therapy"],"prefix":"10.3390","volume":"24","author":[{"given":"Ana","family":"M\u00e1rquez-L\u00f3pez","sequence":"first","affiliation":[{"name":"The Nanomedicine Group, Institute Valdecilla-IDIVAL, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-311X","authenticated-orcid":false,"given":"M\u00f3nica L.","family":"Fanarraga","sequence":"additional","affiliation":[{"name":"The Nanomedicine Group, Institute Valdecilla-IDIVAL, 39011 Santander, Spain"},{"name":"Molecular Biology Department, Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2533","DOI":"10.2147\/IJN.S202210","article-title":"Enzyme-responsive mesoporous silica nanoparticles for tumor cells and mitochondria multistage-targeted drug delivery","volume":"14","author":"Naz","year":"2019","journal-title":"Int. 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