Vaccine adjuvants--understanding molecular mechanisms to improve vaccines

Swiss Med Wkly. 2014 May 20:144:w13940. doi: 10.4414/smw.2014.13940. eCollection 2014.

Abstract

Infectious pathogens are responsible for high utilisation of healthcare resources globally. Attributable morbidity and mortality remains exceptionally high. Vaccines offer the potential to prime a pathogen-specific immune response and subsequently reduce disease burden. Routine vaccination has fundamentally altered the natural history of many frequently observed and serious infections. Vaccination is also recommended for persons at increased risk of severe vaccine-preventable disease. Many current nonadjuvanted vaccines are poorly effective in the elderly and immunocompromised populations, resulting in nonprotective postvaccine antibody titres, which serve as surrogate markers for protection. The vaccine-induced immune response is influenced by: (i.) vaccine factors i.e., type and composition of the antigen(s), (ii.) host factors i.e., genetic differences in immune-signalling or senescence, and (iii.) external factors such as immunosuppressive drugs or diseases. Adjuvanted vaccines offer the potential to compensate for a lack of stimulation and improve pathogen-specific protection. In this review we use influenza vaccine as a model in a discussion of the different mechanisms of action of the available adjuvants. In addition, we will appraise new approaches using "vaccine-omics" to discover novel types of adjuvants.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adjuvants, Immunologic* / physiology
  • Aluminum Compounds / immunology*
  • Drug Discovery
  • Humans
  • Immunity, Cellular
  • Influenza Vaccines / immunology*
  • Peptides / immunology
  • Vaccine Potency*

Substances

  • Adjuvants, Immunologic
  • Aluminum Compounds
  • Influenza Vaccines
  • Peptides