Kraan Heleen, Vrieling Hilde, Czerkinsky Cecil, Jiskoot Wim, Kersten Gideon, Amorij Jean-Pierre
Intravacc (Institute for Translational Vaccinology), Bilthoven, The Netherlands.
Division of Drug Delivery Technology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, Leiden, The Netherlands.
J Control Release. 2014 Sep 28;190:580-92. doi: 10.1016/j.jconrel.2014.05.060. Epub 2014 Jun 6.
Because of their large surface area and immunological competence, mucosal tissues are attractive administration and target sites for vaccination. An important characteristic of mucosal vaccination is its ability to elicit local immune responses, which act against infection at the site of pathogen entry. However, mucosal surfaces are endowed with potent and sophisticated tolerance mechanisms to prevent the immune system from overreacting to the many environmental antigens. Hence, mucosal vaccination may suppress the immune system instead of induce a protective immune response. Therefore, mucosal adjuvants and/or special antigen delivery systems as well as appropriate dosage forms are required in order to develop potent mucosal vaccines. Whereas oral, nasal and pulmonary vaccine delivery strategies have been described extensively, the sublingual and buccal routes have received considerably less attention. In this review, the characteristics of and approaches for sublingual and buccal vaccine delivery are described and compared with other mucosal vaccine delivery sites. We discuss recent progress and highlight promising developments in the search for vaccine formulations, including adjuvants and suitable dosage forms, which are likely critical for designing a successful sublingual or buccal vaccine. Finally, we outline the challenges, hurdles to overcome and formulation issues relevant for sublingual or buccal vaccine delivery.
由于其较大的表面积和免疫活性，黏膜组织是疫苗接种颇具吸引力的给药部位和靶点。黏膜疫苗接种的一个重要特征是其引发局部免疫反应的能力，这种反应可抵御病原体进入部位的感染。然而，黏膜表面具备强大而复杂的耐受机制，以防止免疫系统对众多环境抗原过度反应。因此，黏膜疫苗接种可能会抑制免疫系统而非诱导保护性免疫反应。所以，为了研发有效的黏膜疫苗，需要黏膜佐剂和/或特殊的抗原递送系统以及合适的剂型。虽然口服、鼻内和肺部疫苗递送策略已被广泛描述，但舌下和颊部途径受到的关注要少得多。在这篇综述中，描述了舌下和颊部疫苗递送的特点及方法，并与其他黏膜疫苗递送部位进行了比较。我们讨论了近期的进展，并强调了在寻找疫苗制剂（包括佐剂和合适的剂型）方面有前景的发展，这些制剂对于设计成功的舌下或颊部疫苗可能至关重要。最后，我们概述了与舌下或颊部疫苗递送相关的挑战、需要克服的障碍以及制剂问题。
