Department of Vaccinology and Applied Micobiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, D-38124, Braunschweig, Germany.
Adv Exp Med Biol. 2009;655:171-88. doi: 10.1007/978-1-4419-1132-2_13.
Vaccination remains the most valuable tool for preventing infectious diseases. However, the performance of many existing vaccines should be improved and there are diseases for which vaccines are still not available. The use of well-defined antigens for the generation of subunit vaccines has led to products with an improved safety profile. However, purified antigens are usually poorly immunogenic, making essential the use of adjuvants. Despite the fact that adjuvants have been used to increase the immunogenicity of vaccines for more than 70 years, only a handful has been licensed for human use (e.g., aluminium salts, the micro-fluidized squalene-in-water emulsion MF59 and monophosphoryl lipid A). Thus, the development of new adjuvants which are able to promote broad and sustained immune responses at systemic and mucosal levels still remains as a major challenge in vaccinology. Recent advances in our understanding of the immune system have facilitated the identification of new biological targets for screening programs aimed at the discovery of novel immune stimulators. This resulted in the identification of new candidate adjuvants, which made possible the modulation of the immune responses elicited according to specific needs. A number of promising adjuvants which are currently under preclinical or clinical development will be described in this chapter.
疫苗接种仍然是预防传染病最有价值的工具。然而，许多现有疫苗的性能需要提高，而且还有一些疾病仍然没有疫苗可用。使用定义明确的抗原来生成亚单位疫苗已经导致了安全性更好的产品。然而，纯化的抗原通常免疫原性差，因此必须使用佐剂。尽管佐剂已被用于提高疫苗的免疫原性超过 70 年，但只有少数几种佐剂已被批准用于人类使用（例如，铝盐、微流化角鲨烯水乳液 MF59 和单磷酰脂质 A）。因此，开发能够在全身和黏膜水平促进广泛和持续免疫反应的新型佐剂仍然是疫苗学的主要挑战。我们对免疫系统的理解的最新进展促进了针对新型免疫刺激剂的筛选计划的新生物靶标的鉴定。这导致了新的候选佐剂的鉴定，使根据特定需求调节所引起的免疫反应成为可能。本章将描述一些有前景的佐剂，它们目前正在临床前或临床开发中。
