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This is an oral combination vaccine candidate composed of a formalin-inactivated whole-cell *Shigella flexneri* 2a (Sf2aWC) and the double mutant *Escherichia coli* heat-labile toxin (dmLT; LT R192G/L211A) as a mucosal adjuvant. The primary indication is prevention of shigellosis caused by *Shigella flexneri* 2a, a major cause of severe diarrhea worldwide. The inactivated bacterial component induces immune responses against the lipopolysaccharide (LPS) and other antigens of *S. flexneri* 2a, while the dmLT adjuvant enhances both systemic and mucosal immunity by promoting IL-17A production from CD4+ T cells via antigen-presenting cells and cytokines such as IL-1β and IL-23[3][6][8]. Clinical studies have shown that this combination is safe, well-tolerated, immunogenic in adults, and capable of inducing robust anti-LPS antibody responses[3][5]. The addition of dmLT aims to further boost mucosal immune responses for improved protection.
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