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1761358 
Journal Article 
Cationic Liposomes Formulated with Synthetic Mycobacterial Cordfactor (CAF01): A Versatile Adjuvant for Vaccines with Different Immunological Requirements 
Agger, EM; Rosenkrands, Ida; Hansen, Jon; Brahimi, K; Vandahl, BS; Aagaard, C; Werninghaus, K; Kirschning, C; Lang, R; Christensen, D; Theisen, M; Follmann, F; Andersen, P 
2008 
1 
PLoS ONE
EISSN: 1932-6203 
3 
9 
18776936 
WOS:000264424300001 
Background: It is now emerging that for vaccines against a
range of diseases including influenza, malaria and HIV, the induction of a humoral response is
insufficient and a substantial complementary cell-mediated immune response is necessary for
adequate protection. Furthermore, for some diseases such as tuberculosis, a cellular response
seems to be the sole effector mechanism required for protection. The development of new adjuvants
capable of inducing highly complex immune responses with strong antigen-specific T-cell responses
in addition to antibodies is therefore urgently needed. Methods and Findings: Herein, we describe
a cationic adjuvant formulation (CAF01) consisting of DDA as a delivery vehicle and synthetic
mycobacterial cordfactor as immunomodulator. CAF01 primes strong and complex immune responses and
using ovalbumin as a model vaccine antigen in mice, antigen specific cell-mediated-and humoral
responses were obtained at a level clearly above a range of currently used adjuvants (Aluminium,
monophosphoryl lipid A, CFA/IFA, Montanide). This response occurs through Toll-like receptor 2,
3, 4 and 7-independent pathways whereas the response is partly reduced in MyD88-deficient mice.
In three animal models of diseases with markedly different immunological requirement;
Mycobacterium tuberculosis (cell-mediated), Chlamydia trachomatis (cell-mediated/humoral) and
malaria (humoral) immunization with CAF01-based vaccines elicited significant protective immunity
against challenge. Conclusion: CAF01 is potentially a suitable adjuvant for a wide range of
diseases including targets requiring both CMI and humoral immune responses for protection.