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Components of Bordetella pertussis that are important in the organism's ability to cause disease include: (1) tracheal cytotoxin that destroys cilia, making it difficult to clear thickened mucus; (2) pertussis toxin (also called lymphocytosis-promoting factor), which interferes with immune cell function, contributes to ciliary damage, and aids attachment to respiratory epithelium; (3) filamentous hemagglutinin, which helps the bacteria attach to cilia of the respiratory tract; (4) pertactin (also called 69 kilodalton protein), which also aids bacterial attachment to cilia; and (5) agglutinogens, which may aid persistent attachment to cilia.