Expression of costimulatory molecules is significantly upregulated in various organs in an animal model of severe hepatitis induced by injection of Propionibacterium acnes (P. acnes) and lipopolysaccharide (LPS). In the present study, we examined whether blockade of costimulatory signals by CTLA-4Ig can suppress the liver injury in this model. We injected an adenovirus encoding CTLA-4Ig (AdCTLA-4Ig) into mice 7 days before, on the same day, or 3 days after P. acnes priming. The virus was found to infect the liver preferentially, and CTLA-4Ig was detected in the serum as early as 2 days after viral injection. After injection of LPS, liver injury and survival rates were examined. Most of the mice not injected with AdCTLA-4Ig died within 12 hours after injection of LPS. In contrast, all the AdCTLA-4Ig-injected mice survived when the virus was injected 7 days before or on the same day as P. acnes priming. Importantly, hemorrhagic liver injury and serum alanine aminotransferase levels were significantly reduced after LPS injection even when AdCTLA-4Ig was injected 3 days after P. acnes priming. Immunological analyses showed that CTLA-4Ig inhibited the activation and expansion of P. acnes-specific CD4 ؉ T cells in the hepatic lymph nodes, leading to a reduction in the recruitment of the cells to the liver. The total amounts of interferon-␥, interleukin-12, and various chemokines in the liver were then decreased, resulting in inhibition of the secondary recruitment of not only T cells but also macrophages. A ntigen presentation to naïve T cells by dendritic cells (DCs) is essential for the activation of antigen-specific T cells, and two signals are known to be necessary for activation. 1 The first signal is from the interaction between the T-cell receptor and antigen peptide-human leukocyte antigen complex, and the second, a costimulatory signal, is from the binding of CD80 or CD86 on DCs and CD28 on T cells. Once activated, T cells express cytotoxic T-lymphocyte antigen-4 (CTLA-4) on their surface, and receive a negative signal through binding with CD80 or CD86 on DCs. 2 CTLA-4 thus acts as a negative feedback molecule in the immune response. 3 CTLA-4Ig is a fusion protein, consisting of the extracellular domain of mouse CTLA-4 and a human immunoglobulin (Ig) Fc fragment. CTLA-4Ig binds to CD80 or CD86 on DCs and induces anergy of antigen-specific T cells through interference with binding between costimulatory molecules on DCs and CD28 on T cells. 4,5 Mice with severe liver injury induced by injection of Propionibacterium acnes (P. acnes) and lipopolysaccharide (LPS) is one of the most commonly used animal models of fulminant hepatitis. In this model, all the animals die of liver injury, and there are two different phases in the immune response-a priming phase in which the injection of P. acnes generates granulomas, and an eliciting phase in