Beran Jirí
Centre of vaccination and travel medicine, Hradec Králové, Czech Republic.
Klin Mikrobiol Infekc Lek. 2008 Feb;14(1):5-12.
The so called "first generation adjuvants" have been based on aluminium salts and they were added to vaccines composition to enhance immune response to vaccine antigen. Formerly produced vaccines contained inactivated or attenuated microorganisms, which were able to promote all necessary signals for high immune response. Nevertheless there was also produced immune response and also adverse events to antigens, which were not necessary for protection. Vaccinology has been further developed with possibility to produce recombinant and subunit antigens, which were needed for protection against infection. It was necessary to intensify targeted immune response against recombinant antigen, for fast and long term protection. Such need stimulated research for development of "adjuvanted systems of the second generation", which were tailored to particular antigen. Former adjuvants were based on stimulation of adaptive immunity. Contrary the first the second generation of adjuvanted systems is based on Pathogen-Associated Molecular Patterns (PAMP). By binding to Toll-like receptors (mostly TLR-4) as a part of innate immunity, they are able to influence adaptive immunity including humoral and also cellular arm of immune system. Licensed vaccines with second generation of adjuvant systems are Cervarix and Fendrix vaccines and in development are vaccines against malaria and genital herpes. Also for pre-pandemic vaccines is used new generation of adjuvanted systems.
所谓的“第一代佐剂”是以铝盐为基础的，它们被添加到疫苗组合物中以增强对疫苗抗原的免疫反应。以前生产的疫苗含有灭活或减毒的微生物，这些微生物能够促进产生高免疫反应所需的所有信号。然而，也会产生对保护并非必需的抗原的免疫反应以及不良事件。随着能够生产用于预防感染的重组和亚单位抗原，疫苗学得到了进一步发展。为了实现快速和长期的保护，有必要增强针对重组抗原的靶向免疫反应。这种需求推动了对“第二代佐剂系统”的研发，这些系统是针对特定抗原量身定制的。以前的佐剂基于对适应性免疫的刺激。与第一代相反，第二代佐剂系统基于病原体相关分子模式（PAMP）。作为固有免疫的一部分，它们通过与Toll样受体（主要是TLR-4）结合，能够影响适应性免疫，包括免疫系统的体液免疫和细胞免疫分支。含有第二代佐剂系统的已获许可疫苗有希瑞适疫苗和富适递疫苗，正在研发的有抗疟疾和生殖器疱疹的疫苗。新一代佐剂系统也用于大流行前疫苗。
