Immunostimulant Patch Containing Heat-Labile Enterotoxin from Escherichia
coli Enhances Immune Responses to Injected Influenza Virus Vaccine through
Activation of Skin Dendritic Cells
Mimi Guebre-Xabier, Scott A. Hammond, Diane E. Epperson, Jianmei Yu,
Larry Ellingsworth, and Gregory M. Glenn*
IOMAI Corporation, Gaithersburg, Maryland 20878
Received 29 October 2002/ Accepted 7 February 2003
Vaccine strategies, such as influenza virus vaccination of theelderly, are highly effective at preventing disease but provide
protection for only the responding portion of the vaccinees.
Adjuvants improve the magnitude and rates of responses, buttheir
potency must be attenuated to minimize side effects. Topicaldelivery
of strong adjuvants such as heat-labile enterotoxinfrom
Escherichia coli (LT) induces potent immune responses.We
hypothesized that LT delivered alone in an immunostimulating(LT-IS)
patch placed on the skin at the site of injection couldaugment the
immune response to injected vaccines. This was basedon the
observation that topically applied LT induces migrationof activated
antigen-presenting cells (APCs) from the skin tothe proximal
draining lymph node (DLN), and that APCs loadedwith antigen by
injection in the same anatomical region alsomigrate to the same DLN.
We observed that when influenza virusvaccine is injected and an
LT-IS patch is placed to target thesame DLN, the influenza virus
antibody response is enhanced.Similarly, influenza virus-specific T
cells isolated from thelungs show increased levels of gamma
interferon and interleukin-4production. An LT-IS patch placed near
an injected vaccine alsoleads to increased levels of
hemagglutination inhibition titers,enhanced mucosal immunoglobulin A
responses, and enhanced antigenpresentation. Although the mechanisms
by which an LT-IS patchexerts its enhancing effects need further
study, the enhancedimmune responses, ability to safely use potent
adjuvants, andsimplicity of LT-IS patch application address an
important unmetneed and provide a new immune enhancement strategy.
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