Cholera toxin (CT) is a potent adjuvant that activates dendritic cells (DC) by increasing intracellular cyclic AMP (cAMP) levels. In vivo and in vitro, very small amounts of CT induce potent adjuvant effects and activate DC. We hypothesized that DC intoxicated by CT may release factors that enhance their own maturation and induce the maturation of toxin-free bystander DC. Through the use of mixed cultures and transwell cultures, we found that human monocyte-derived DC (MDDC) pulsed with CT or other cAMP-elevating agonists induce the maturation of bystander DC. Many DC agonists including CT increase the production of prostaglandin E 2 (PGE 2 ) and nitric oxide (NO). For this reason, we determined whether the actions of PGE 2 or NO are involved in the maturation of MDDC induced by CT or dibutyryl-cAMP (d-cAMP). We found that blocking the production of PGE 2 or blocking prostaglandin receptors inhibited MDDC maturation induced by CT and d-cAMP. Likewise, sequestering NO or blocking the downstream actions of NO resulted in the inhibition of MDDC maturation induced by CT and d-cAMP. These results indicate that endogenously produced factors including PGE 2 and NO contribute to the maturation of DC induced by CT and that these factors participate in bystander DC maturation. The results of this study may help explain why bacterial toxins that elevate cAMP are such potent adjuvants.Understanding the intercellular and intracellular signaling processes that lead to dendritic cell (DC) maturation is important for determining how these cells initiate immune responses to foreign antigens. Monocyte-derived DC (MDDC), produced by culturing monocytes with granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) for 6 to 7 days, are phenotypically equivalent to the immature DC that reside in peripheral tissues (45). However, it is becoming increasingly evident that the kinetics of in vivo DC differentiation from monocytes may not be reflected by the long-term in vitro culture conditions required to generate MDDC. A recent study showed that mature DC can be generated from human monocytes in as little as 48 h (14). We have studied the transition of monocytes to DC in vitro and have also generated a shortened protocol for the in vitro generation of DC. With our protocol, MDDC are matured after only 4 days of culture in the presence of GM-CSF and IL-4 (2-4). In our hands, MDDC at day 4 are more responsive to activation than MDDC at days 5 to 7.Cholera toxin (CT) is an AB5 enterotoxin produced by Vibrio cholerae, the primary causative agent of the disease cholera. CT consists of a 27-kDa catalytic A domain anchored in a ring of five identical 11.7-kDa B subunits (40). The B pentamer of CT binds to GM1 gangliosides on cell membranes (28). CT has a Lys/Arg-Asp-Glu-Leu ([K/R]DEL) signal sequence at the C terminus of its A domain. This sequence is believed to target the toxin to the endoplasmic reticulum, where the A1 subunit (disguised as a misfolded host protein) is transported to the cytoplasm by the endoplasm...