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Pseudomonas aeruginosa injection, also known by the brand name Vantepuan (万特普安), is an immunotherapeutic agent derived from an inactivated, genetically engineered strain of *Pseudomonas aeruginosa* known as PA-MSHA (mannose-sensitive hemagglutinin). [2, 9] This biologic was developed by Beijing Wanter Bio-pharm Co., Ltd. and is approved in China as an adjuvant therapy for malignant tumors. [3, 9, 6] The preparation consists of heat- or chemically-killed bacteria that express high levels of type I fimbriae, which are mannose-sensitive hemagglutinins. [9, 6, 18] The mechanism of action involves stimulating the host's immune system. [6] It triggers immunogenic cell death, including pyroptosis and apoptosis, in tumor cells. [2] It also activates the innate immune system by engaging Toll-like receptors (TLRs) like TLR4, leading to the maturation of dendritic cells, activation of NK cells and macrophages, and increased infiltration of CD4+ and CD8+ T cells into the tumor microenvironment. [9, 10] This reprogramming of the tumor microenvironment can overcome resistance to other therapies and enhance the efficacy of treatments like chemotherapy and immune checkpoint inhibitors. [2] Common side effects are related to immune activation and include fever and local skin irritation at the injection site. [2, 4]
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