Adjuvant

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Microscopic image illustrating vaccine adjuvant response.

Vaccine adjuvants are substances added to vaccine formulations to enhance the body's immune response to an antigen. By boosting immunogenicity, adjuvants enable vaccines to provide more effective and longer-lasting protection against infectious diseases.

Overview

Adjuvants play a vital role in immunization, especially for inactivated vaccines and subunit vaccines, which contain non-living or partial pathogen components. These vaccines often require assistance in stimulating adequate immunity, which is where adjuvants come in. The first widely used adjuvant, alum (aluminium salts), has been in use since the 1920s.

Mechanism of Action

Adjuvants work by enhancing various aspects of the immune system:

• They create a depot effect, allowing antigens to persist longer at the injection site.
• They attract immune cells, such as dendritic cells and macrophages, promoting antigen presentation.
• They stimulate cytokine production and inflammation, which help initiate adaptive immunity.
• Some mimic pathogen-associated molecular patterns (PAMPs), triggering innate responses via toll-like receptors (TLRs).

Common Types of Adjuvants

Several classes of adjuvants are currently used or under development:

• Aluminium salts: Includes aluminium hydroxide, aluminium phosphate, and aluminium potassium sulfate (alum).
• Oil-in-water emulsions: Examples include MF59 and AS03, used in influenza vaccines.
• Liposomes: Spherical vesicles that deliver antigens directly to antigen-presenting cells.
• Bacterial derivatives: Such as monophosphoryl lipid A (MPL), derived from lipopolysaccharides.
• Saponin-based adjuvants: For example, QS-21 derived from the bark of the Quillaja saponaria tree.

Benefits

• Enhances antibody and T-cell responses
• Enables lower antigen doses (dose sparing)
• Prolongs immunity duration
• Improves response in elderly or immunocompromised individuals
• Reduces the number of booster shots required

Safety and Regulation

Adjuvants are regulated by global health agencies including the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). They undergo extensive preclinical and clinical trial testing to evaluate:

• Toxicity
• Immunogenicity
• Potential for autoimmunity
• Long-term effects

Research and development of novel adjuvants in immunology labs.

Challenges and Research

Current research into next-generation adjuvants aims to:

• Develop targeted immune responses for diseases like HIV, malaria, and tuberculosis
• Reduce side effects while maintaining efficacy
• Personalize adjuvants for age, health status, or genetic predisposition
• Explore synthetic and biodegradable adjuvant systems

Function and Use

Vaccine adjuvants act as immune potentiators. By enhancing recognition of vaccine antigens by B cells and T cells, they:

• Promote antigen uptake
• Boost cytokine production
• Strengthen memory immune response

Safety and Efficacy

Adjuvants undergo the same level of scrutiny as any other vaccine component. Although local side effects such as injection site reactions may occur, adjuvants have been proven safe in hundreds of millions of doses worldwide.

See Also

• Adjuvant therapy
• Vaccination
• Immunology
• Antigen
• Vaccine efficacy
• Cytokine
• Toll-like receptor

External Links

• CDC – Vaccine Adjuvants
• WHO – Immunological Adjuvants (PDF)
• FDA – Vaccine Adjuvants