Moraxella catarrhalis is an important human mucosal pathogen. This study investigated the effect of intranasal immunization with a detoxified-lipooligosaccharide-cross-reactive mutant of diphtheria toxin (dLOS-CRM) vaccine candidate on pulmonary clearance following an aerosol challenge of mice with M. catarrhalis. Intranasal immunization with dLOS-CRM plus cholera toxin induced a significantly dose-dependent increase of immunoglobulin A (IgA) and IgG in the nasal wash, lung lavage fluid, saliva, and fecal extract. In addition, serum IgG, IgM, and IgA against LOS of M. catarrhalis were detected. LOS-specific antibody-forming cells were found in the nasal passages, spleens, nasally associated lymphoid tissues, cervical lymph nodes, lungs, and Peyer's patches using an enzyme-linked immunospot assay. The dLOS-CRM vaccine induced a significant bacterial clearance (70 to 90%) of both homologous and heterologous strains in the lungs compared to that observed in the controls (P < 0.01). Intriguingly, intranasal immunization with dLOS-CRM showed a higher level of bacterial clearance compared with subcutaneous injections with dLOS-CRM. These data indicate that dLOS-CRM induces specific mucosal and systemic immunity through intranasal immunization and also provides effective bacterial clearance. On the basis of these results, we believe that dLOS-CRM should undergo continued testing to determine whether it would induce protective immune response in humans.The mucosal surfaces of the respiratory, genitourinary, and gastrointestinal tracts consist of an efficient physical barrier against environmental pathogens. However, a majority of bacterial and viral infections directly affect or enter the body through mucosal surfaces, and colonization at these sites is the first step in pathogenesis. Moraxella catarrhalis is a gram-negative human mucosal pathogen which causes middle ear infections in children as well as lower respiratory tract infections in adults with chronic pulmonary disease (8,9,22,28). In young children, M. catarrhalis is one of the three major causes of otitis media (OM) along with Streptococcus pneumoniae and nontypeable Haemophilus influenzae. More than 80% of children are likely to experience at least one episode of OM by the age of 2 years. Recurrent or chronic OM can lead to hearing, speech, and/or language problems. The estimated cost from OM in the United States is $5 billion annually (23). In the elderly, especially those with chronic obstructive pulmonary diseases, M. catarrhalis can cause severe lower respiratory tract infections such as pneumonia that can be life threatening (38). Currently, the number of antibiotic-resistant strains of M. catarrhalis has significantly increased (4, 13).Active immunization with an effective vaccine would be an efficient approach to prevent such infections (27). Efforts have therefore been made to evaluate surface antigens of M. catarrhalis such as outer membrane proteins (6,11,29,30) and lipooligosaccharide (LOS) as candidate vaccines, which may elicit protective antib...