Gupta R K, Relyveld E H, Lindblad E B, Bizzini B, Ben-Efraim S, Gupta C K
Massachusetts Public Health Biologic Laboratories, Boston 02130.
Vaccine. 1993;11(3):293-306. doi: 10.1016/0264-410x(93)90190-9.
Adjuvants have been used to augment the immune response in experimental immunology as well as in practical vaccination for more than 60 years. The chemical nature of adjuvants, their mode of action and the profile of their side effects are highly variable. Some of the side effects can be ascribed to an unintentional stimulation of different mechanisms of the immune system whereas others may reflect general adverse pharmacological reactions. The most common adjuvants for human use today are still aluminium hydroxide, aluminium phosphate and calcium phosphate although oil emulsions, products from bacteria and their synthetic derivatives as well as liposomes have also been tested or used in humans. In recent years monophosphoryl lipid A, ISCOMs with Quil-A and Syntex adjuvant formulation (SAF) containing the threonyl derivative of muramyl dipeptide have been under consideration for use as adjuvants in humans. At present the choice of adjuvants for human vaccination reflects a compromise between a requirement for adjuvanticity and an acceptable low level of side effects.
60多年来，佐剂一直被用于增强实验免疫学以及实际疫苗接种中的免疫反应。佐剂的化学性质、作用方式及其副作用情况差异很大。有些副作用可归因于对免疫系统不同机制的无意刺激，而其他副作用可能反映了一般的不良药理反应。目前人类最常用的佐剂仍然是氢氧化铝、磷酸铝和磷酸钙，不过油乳剂、细菌产物及其合成衍生物以及脂质体也已在人体中进行了测试或使用。近年来，单磷酰脂质A、含Quil-A的免疫刺激复合物以及含有胞壁酰二肽苏氨酰衍生物的Syntex佐剂配方（SAF）已被考虑用作人类佐剂。目前，人类疫苗接种中佐剂的选择反映了在佐剂性需求和可接受的低副作用水平之间的权衡。
