Abstract
Influenza poses a huge threat to global public health. Influenza vaccines are the most effective and cost-effective means to control influenza. Current influenza vaccines mainly induce neutralizing antibodies against highly variable globular head of hemagglutinin and lack cross-protection. Vaccine adjuvants have been approved to enhance seasonal influenza vaccine efficacy in the elderly and spare influenza vaccine doses. Clinical studies found that MF59 and AS03-adjuvanted influenza vaccines could induce cross-protective immunity against non-vaccine viral strains. In addition to MF59 and AS03 adjuvants, experimental adjuvants, such as Toll-like receptor agonists, saponin-based adjuvants, cholera toxin and heat-labile enterotoxin-based mucosal adjuvants, and physical adjuvants, are also able to broaden influenza vaccine-induced immune responses against non-vaccine strains. This review focuses on introducing the various types of adjuvants capable of assisting current influenza vaccines to induce cross-protective immunity in preclinical and clinical studies. Mechanisms of licensed MF59 and AS03 adjuvants to induce cross-protective immunity are also introduced. Vaccine adjuvants hold a great promise to adjuvant influenza vaccines to induce cross-protective immunity.
Highlights
Influenza is a highly contagious viral infectious disease [1]
This review focuses on introducing vaccine adjuvants that are capable of assisting current influenza vaccines to induce broad cross-protective immunity
This review focuses on introducing vaccine adjuvants capable of assisting current influenza vaccines to induce cross-protective immunity
Summary
Influenza is a highly contagious viral infectious disease [1]. Based on the World Health. Human influenza is often caused by type A and B viruses [3]. The annual mutation rates for the non-structural genes of influenza A and B viruses are about. The high mutation rates of influenza A viruses cause frequent sequence changes of HA, leading to antigenic drift [3,9,10]. Antigenic drift enables influenza viruses to evade host immune surveillance and cause epidemics [3,9]. The co-infection of different influenza A subtypes can cause reassortment, a process by which influenza viruses exchange gene segments and generate new viruses [9]. Due to the lack of preexisting immunity, the reassortant viruses have a high risk to cause influenza pandemics if sufficient human-to-human transmission can be established [9,11,12]. This review focuses on introducing vaccine adjuvants that are capable of assisting current influenza vaccines to induce broad cross-protective immunity
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