Advances in vaccine adjuvants for infectious diseases.

A HIV Vaccine, particularly that based on recombinant proteins and plasmid DNA, is likely to be less reactogenic than traditional vaccines, but also less immunogenic. Therefore, there is an urgent need for the development of new and improved adjuvants and delivery system for combination with HIV vaccine antigens. Adjuvants can be broadly separated into two classes, based on their principal mechanisms of action; "vaccine delivery systems" and "immunostimulatory adjuvants". Vaccine delivery systems are generally particulate formulations e.g. emulsions, microparticles, iscoms and liposomes, and mainly function to target associated antigens into antigen presenting cells (APC). In contrast, immunostimulatory adjuvants are predominantly derived from pathogens and often represent pathogen associated molecular patterns (PAMP) e.g. LPS, MPL, CpG DNA, which activate cells of the innate immune system. The discovery of more potent adjuvants may allow the development of prophylactic and therapeutic vaccines against HIV. In addition, new adjuvants may also allow vaccines to be delivered mucosally.