The Mucosal Vaccine Adjuvant LT(R192G/L211A) or DmLT

Overview

Journal mSphere

Publisher American Society for Microbiology

Specialties Microbiology
Parasitology

Date 2018 Jul 27

PMID 30045966

Citations 109

Authors

John D Clements

Elizabeth B Norton

Affiliations

Soon will be listed here.

Abstract

Perhaps the best-studied mucosal adjuvants are the bacterially derived ADP-ribosylating enterotoxins. This adjuvant family includes heat-labile enterotoxin of (LT), cholera toxin (CT), and mutants or subunits of LT and CT. These proteins promote a multifaceted antigen-specific response, including inflammatory Th1, Th2, Th17, cytotoxic T lymphocytes (CTLs), and antibodies. However, more uniquely among adjuvant classes, they induce antigen-specific IgA antibodies and long-lasting memory to coadministered antigens when delivered mucosally or even parenterally. The purpose of this minireview is to describe the general properties, history and creation, preclinical studies, clinical studies, mechanisms of action, and considerations for use of the most promising enterotoxin-based adjuvant to date, LT(R192G/L211A) or dmLT. This review is timely due to completed, ongoing, and planned clinical investigations of dmLT in multiple vaccine formulations by government, nonprofit, and industry groups in the United States and abroad.

Citing Articles

Protective antibodies against enterotoxigenic Escherichia coli are generated from heat-labile toxoid vaccination and exhibit subject- and vaccine-specific diversity.

Maciel Jr M, Scott J, Baudier R, Clements J, Laird R, Gutierrez R Med Microbiol Immunol. 2025; 214(1):10.

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Safety and immunogenicity in humans of enterotoxigenic Escherichia coli double mutant heat-labile toxin administered intradermally.

Pasetti M, Milletich P, White J, Butts J, Brady R, Dickey M NPJ Vaccines. 2025; 10(1):23.

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