BCG, the attenuated strain of Mycobacterium bovis, has been widely used as a vaccine against tuberculosis and is thus an important candidate as a live carrier for multiple antigens. With the aim of developing a recombinant BCG (rBCG) vaccine against diphtheria, pertussis, and tetanus (DPT), we analyzed the potential of CRM 197 , a mutated nontoxic derivative of diphtheria toxin, as the recombinant antigen for a BCG-based vaccine against diphtheria. Expression of CRM 197 in rBCG was achieved using Escherichia coli-mycobacterium shuttle vectors under the control of pBlaF*, an upregulated â€-lactamase promoter from Mycobacterium fortuitum. Immunization of mice with rBCG-CRM 197 elicited an anti-diphtheria toxoid antibody response, but the sera of immunized mice were not able to neutralize diphtheria toxin (DTx) activity. On the other hand, a subimmunizing dose of the conventional diphtheria-tetanus vaccine, administered in order to mimic an infection, showed that rBCG-CRM 197 was able to prime the induction of a humoral response within shorter periods. Interestingly, the antibodies produced showed neutralizing activity only when the vaccines had been given as a mixture in combination with rBCG expressing tetanus toxin fragment C (FC), suggesting an adjuvant effect of rBCG-FC on the immune response induced by rBCG-CRM 197 . Isotype analysis of the anti-diphtheria toxoid antibodies induced by the combined vaccines, but not rBCG-CRM 197 alone, showed an immunoglobulin G1-dominant profile, as did the conventional vaccine. Our results show that rBCG expressing CRM 197 can elicit a neutralizing humoral response and encourage further studies on the development of a DPT vaccine with rBCG.Many currently used vaccines require multiple doses to achieve maximum protection, which has led to reduced coverage of vaccination campaigns, especially in developing countries. The use of live viral or bacterial carriers for heterologous antigen presentation, such as vaccinia virus, Salmonella, and Mycobacterium bovis BCG (Bacille Calmette-GuĂ©rin), has been intensively investigated in an effort to reduce the number of doses required for immunization. M. bovis BCG is the most widely used live vaccine, having been administered as an antituberculosis vaccine to over 3 billion individuals. It has several features that have encouraged its use as a live carrier for recombinant antigens, such as low production cost, possibility of administration at birth with very strong adjuvant activity, induction of immunity after a single dose, and low frequency of side effects. The induction of humoral and cellular immune responses against antigens from several pathogens by recombinant BCG (rBCG) strains has been reported, such as rBCG expressing antigens from human immunodeficiency virus (25, 29), simian immunodeficiency virus (30), Leishmania major (1, 6), Plasmodium falciparum (13), Streptococcus pneumoniae (18), and Borrelia burgdorferi (26).The conventional diphtheria-pertussis-tetanus (DPT) vaccine was shown to be extremely efficient, and the recently...