Application of antigens with an adjuvant onto bare skin is a needle-free and pain-free immunization procedure that delivers antigens to the immunocompetent cells of the epidermis. We tested here the immunogenicity and adjuvanticity of two mutants of heat-labile enterotoxin (LT) of Escherichia coli, LTK63 and LTR72. Both mutants were shown to be immunogenic, inducing serum and mucosal antibody responses. The application of LTK63 and LTR72 to bare skin induced significant protection against intraperitoneal challenge with a lethal dose of LT. In addition, both LT mutants enhanced the capacity of peptides TT:830-843 and HA:307-319 (representing T-helper epitopes from tetanus toxin and influenza virus hemagglutinin, respectively) to elicit antigen-specific CD4 ؉ T cells after coapplication onto bare skin. However, only mutant LTR72 was capable of stimulating the secretion of high levels of gamma interferon. These findings demonstrate that successful skin immunization protocols require the selection of the right adjuvant in order to induce the appropriate type of antigen-specific immune responses in a selective and reliable way. Moreover, the use of adjuvants such the LTK63 and LTR72 mutants, with no or low residual toxicity, holds a lot of promise for the future application of vaccines to the bare skin of humans.Recently, bare skin has emerged as a potential alternative route for vaccine delivery (11,27). This is because the skin is rich in immunocompetent cells (4, 36), and when antigens are applied with a suitable adjuvant either in solution (1,11,13,34) or with a patch (14), they induce potent immune responses. The development of noninvasive immunization procedures, which can be needle free and pain free, is a top priority for public health agencies. This is because many current immunization practices are unsafe, particularly in developing countries due to the widespread reuse of nonsterile syringes (27). Therefore, the topical application of vaccines is attractive since it has the potential to make vaccine delivery more equitable, safer, and efficient. Furthermore, it would greatly facilitate the successful implementation of worldwide mass vaccination campaigns against infectious diseases.For the induction of an effective immune response, the antigen is normally coapplied onto hydrated bare skin with an ADP-ribosylating exotoxin as an adjuvant (i.e., Vibrio cholerae cholera toxin [CT] or Escherichia coli heat-labile enterotoxin [LT]) (1, 11, 13, 34). Both CT and LT are composed of five nontoxic B subunits held together in a pentamer (responsible for binding to the cell membrane), surrounding a single A subunit, which is responsible for toxicity. The A subunit consists of two distinct structural domains: the A1 domain, which displays the ADP-ribosyltransferase activity in the cytosol of the target cells and the A2 domain that interacts with the B-subunit (35). These toxins are responsible for the cause of a debilitating watery diarrhea (35). Moreover, they are potent immunogens and exert an adjuvant effect on ant...