Abstract
Bacillus anthracis is the causative agent of anthrax, a bacterial infection with a high mortality rate [1-3]. Although anthrax infection can be cutaneous, gastrointestinal or pulmonary, the pulmonary form is the most deadly [2,3]. Thus, the release of Bacillus anthracis spores that can be inhaled represents a potent bioterrorism threat; the capacity of B. anthracis spores to act as a bioterrorism weapon was demonstrated in 2001, with the intentional infection of 22 persons in the U.S.A. [2,4]. Until recently, the available vaccines were developed to confer protection against cutaneous infection; despite this, these vaccines demonstrated experimental efficacy against pulmonary infection in multiple animal models [1,2]. Nevertheless, there are many limitations for these vaccines to be considered successful and effective vaccine, including the intensity of the required vaccination schedule, the administration route and the presence of local adverse effects experienced after vaccination [1,3,5,6]. To develop more efficient vaccines against pulmonary anthrax, intranasal formulations with adjuvant have been studied. These formulations have advantages because they are easy to administer and because they are expected to induce both systemic and respiratory tract mucosal immune responses. Therefore, the main goal of this review is to compare the different experimental adjuvants used with anthrax antigens and the different approaches regarding the vaccination schedule and consecutive boosters.
Highlights
Anthrax is a rare bacterial infection that is highly lethal in the inhalational form
The authors’ concluded that poly (I:C) exhibited great potential for mucosal adjuvant; they observed a greater production of anti-protective antigen (PA) IgG and IgA and greater anthrax toxin neutralising activity in bronchoalveolar lavage and serum samples when compared to Cholera Toxin (CT) [2]
The third study, which was published in 2008 [3], showed that nasal immunisation of mice with a prototypic triantigen vaccine candidate comprised of LF, rPA83 and PGABSA associated with poly (I:C) induced strong immune responses against all 3 antigens
Summary
Anthrax is a rare bacterial infection that is highly lethal in the inhalational form. AVA contains very small amounts of EF and LF and large quantities of PA adsorbed into aluminium compounds, while AVP contains comparatively lower levels of PA and higher amounts of additional B. anthracis antigens [2,5,12,17] As these vaccines were originally targeted to protect against cutaneous anthrax, the licensed anthrax vaccines are far from ideal against inhalational anthrax [1,2]. Optimal protection against the most dangerous form of anthrax can be improved and achieved through the induction of specific immunity at spore infection sites, which would lead to a systemic immune response and to the production of antibodies at mucosal surfaces [9,15]. Mucosal administration of rPa combined with other anthrax antigens or with immunopotentiators will constitute the third generation of anthrax vaccines
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