Vaccine Adjuvants: from 1920 to 2015 and Beyond
Abstract
:1. The Evolution of Vaccines
The Immunology of Infection and Immunization
2. The Discovery of Adjuvants
3. New Vaccines: Challenges and Solutions
3.1. Challenging Pathogens
3.2. Challenging Populations
3.3. Potential Solutions for New Vaccines
4. Modern Adjuvants
Adjuvant | Composition | Major Immune Effects | ||
---|---|---|---|---|
(vaccines where used) | Component | Origin | Other Uses | |
Aluminum (D, T, pertussis, IPV, hepatitis A & B, HPV, meningococcal and pneumococcal) | Aluminum as salts mixed with antigen (adsorption) | Naturally occurring present in soil, water, air | Medicines, cosmetics, food industry | Increases local inflammation, improves antigen update by APCs. Acts to increase antibody production |
Virosomes (Hepatitis and influenza) | Vesicles where influenza antigens in aqueous volume are enclosed within a standard phospholipid cell membrane bilayer | Natural phospholipids, Seasonal influenza glycoproteins | None | Increases uptake by APCs. May interact with B cells leading to T-cell activation. |
AS04 (Hepatitis B, HPV) | (3-deacyl-monophosphoryl lipid A) derived from LPS from Salmonella Minnesota, Aluminum salts | Natural exposure to LPS from Gram-negative bacteria occurs frequently | None | Directly stimulates TLR-4 increasing APC maturation and Th1 responses. |
MF59® (Influenza-seasonal and pandemic) | Squalene | Animal source (shark liver oil). Found naturally in human tissues: adipose tissues, skin, arterial walls, skeleton, muscles, lymph nodes | Cosmetics, moisturizers | Increases APC recruitment and activation. Promotes antigen uptake and migration of cells to lymph nodes. |
AS03 (Influenza-pandemic) |
|
|
| Promotes local production of cytokines and recruitment of innate cells. |
Thermo-reversible oil-in-water (Influenza-pandemic) | Squalene | Animal source (shark liver oil). See above | Naturally occurring. See above | Not reported |
ISA51 (therapeutic vaccine NSCLC) | Mineral oil DRAKEOL 6 VR Surfactant mannide-mono-oleate | Refined mineral oil of vegetable origin | Food industry | Strongly immunogenic |
5. Determining the Safety of Adjuvanted Vaccines
Assessment of the Benefit-Risk Ratio
6. Potential Safety Concerns around Adjuvanted Vaccines
6.1. Reactogenicity
6.2. Immune-Mediated Diseases
6.3. Gulf War Syndrome
6.4. Myofasciitis
7. Challenges around Implementing Vaccination Programs with Novel Vaccines
8. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Pasquale, A.D.; Preiss, S.; Silva, F.T.D.; Garçon, N. Vaccine Adjuvants: from 1920 to 2015 and Beyond. Vaccines 2015, 3, 320-343. https://doi.org/10.3390/vaccines3020320
Pasquale AD, Preiss S, Silva FTD, Garçon N. Vaccine Adjuvants: from 1920 to 2015 and Beyond. Vaccines. 2015; 3(2):320-343. https://doi.org/10.3390/vaccines3020320
Chicago/Turabian StylePasquale, Alberta Di, Scott Preiss, Fernanda Tavares Da Silva, and Nathalie Garçon. 2015. "Vaccine Adjuvants: from 1920 to 2015 and Beyond" Vaccines 3, no. 2: 320-343. https://doi.org/10.3390/vaccines3020320