Vaccine adjuvants--understanding molecular mechanisms to improve vaccines.
Infectious pathogens are responsible for high utilisation of healthcare resources globally. Attributable morbidity and mortality remains exceptionally high. Vaccines offer the potential to prime a pathogen-specific immune response and subsequently reduce disease burden. Routine vaccination has fundamentally altered the natural history of many frequently observed and serious infections. Vaccination is also recommended for persons at increased risk of severe vaccine-preventable disease. Many current nonadjuvanted vaccines are poorly effective in the elderly and immunocompromised populations, resulting in nonprotective postvaccine antibody titres, which serve as surrogate markers for protection. The vaccine-induced immune response is influenced by: (i.) vaccine factors i.e., type and composition of the antigen(s), (ii.) host factors i.e., genetic differences in immune-signalling or senescence, and (iii.) external factors such as immunosuppressive drugs or diseases. Adjuvanted vaccines offer the potential to compensate for a lack of stimulation and improve pathogen-specific protection. In this review we use influenza vaccine as a model in a discussion of the different mechanisms of action of the available adjuvants. In addition, we will appraise new approaches using "vaccine-omics" to discover novel types of adjuvants.
Infection Biology, Department of Biomedicine, University Hospital of Basel, SWITZERLAND; a.egli@usb.ch.
Adrian
A
Egli
Clinical Microbiology, University Hospital of Basel, Switzerland.
Deanna
D
Santer
Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada, and Department of Engineering Mathematics and Physics, Fayoum University, Egypt.
Khaled
K
Barakat
Division of Nephrology, University of Rochester Medical Center, School of Medicine and Dentistry, United States of America.
Martin
M
Zand
Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada.
Aviad
A
Levin
Infection Biology, Department of Biomedicine, University Hospital of Basel, Switzerland.
Madeleine
M
Vollmer
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Switzerland.
Maja
M
Weisser
Infection Biology, Department of Biomedicine, University Hospital of Basel, Switzerland, and Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Switzerland.
Nina
N
Khanna
Alberta Transplant Institute, University of Alberta, Edmonton, Canada.
Deepali
D
Kumar
Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada.
Lorne
L
Tyrrell
Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada.
Michael
M
Houghton
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Switzerland.
Manuel
M
Battegay
Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada, and Division of Infectious Diseases, University of Alberta, Edmonton, Canada.
Daire
D
O'Shea
D000276:Adjuvants, Immunologic / Q000502:physiology; D017607:Aluminum Compounds / Q000276:immunology*; D055808:Drug Discovery; D006801:Humans; D007111:Immunity, Cellular; D007252:Influenza Vaccines / Q000276:immunology*; D010455:Peptides / Q000276:immunology; D064166:Vaccine Potency
D000276:Adjuvants, Immunologic; D017607:Aluminum Compounds; D007252:Influenza Vaccines; D010455:Peptides