Edelman Robert
Center for Vaccine Development, University of Maryland School of Medicine, Baltimore 21201, USA.
Mol Biotechnol. 2002 Jun;21(2):129-48. doi: 10.1385/MB:21:2:129.
Interest in vaccine adjuvants is intense and growing, because many of the new subunit vaccine candidates lack sufficient immunogenicity to be clinically useful. In this review, I have emphasized modern vaccine adjuvants injected parenterally, or administered orally, intranasally, or transcutaneously with licensed or experimental vaccines in humans. Every adjuvant has a complex and often multi-factorial immunological mechanism, usually poorly understood in vivo. Many determinants of adjuvanticity exist, and each adjuvanted vaccine is unique. Adjuvant safety is critical and can enhance, retard, or stop development of an adjuvanted vaccine. The choice of an adjuvant often depends upon expensive experimental trial and error, upon cost, and upon commercial availability. Extensive regulatory and administrative support is required to conduct clinical trials of adjuvanted vaccines. Finally, comparative adjuvant trials where one antigen is formulated with different adjuvants and administered by a common protocol to animals and humans can accelerate vaccine development.
人们对疫苗佐剂的兴趣浓厚且不断增长，因为许多新的亚单位候选疫苗缺乏足够的免疫原性，无法在临床上发挥作用。在这篇综述中，我重点介绍了现代疫苗佐剂，这些佐剂通过皮下注射，或与人类已获许可或正在试验的疫苗一起经口服、鼻内给药或经皮给药。每种佐剂都有复杂且通常是多因素的免疫机制，在体内通常了解甚少。存在许多佐剂效应的决定因素，每种含佐剂疫苗都是独特的。佐剂安全性至关重要，它可以促进、延缓或终止含佐剂疫苗的研发。佐剂的选择通常取决于昂贵的实验尝试、成本以及商业可得性。开展含佐剂疫苗的临床试验需要广泛的监管和行政支持。最后，将一种抗原与不同佐剂配制，并按照通用方案给动物和人类接种的比较性佐剂试验，可以加速疫苗研发。
