Professional Documents
Culture Documents
discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/262799167
CITATIONS READS
3 796
1 author:
Vasso Apostolopoulos
Victoria University Melbourne
245 PUBLICATIONS 6,466 CITATIONS
SEE PROFILE
Some of the authors of this publication are also working on these related projects:
All content following this page was uploaded by Vasso Apostolopoulos on 22 July 2014.
than it was 50 or more years ago. Vaccines must now meet New-generation vaccines
higher standards of safety and biochemical characterization The book ‘New Generation Vaccines’, by a distinguished editor
than they did in the past. Some of the vaccines developed in and associate editors, is a timely book in this important era in
the past would not even meet the minimum standards required the development of new-generation vaccines. The book includes
today. Thus, for a vaccine regime to be successful today, one 89 up-to-date chapters in the development of vaccines. The
needs to use new molecular and biological techniques that have chapters are clear and informative, with key tables and figures.
been developed in the last 10 years – these techniques are use- The book begins with a chapter on historical perspectives and
ful in the generation of new and improved vaccines. Advances immediately enters into modern methods of defining vaccine
in the fields of molecular biology, chemistry and immunology antigens by reverse vaccinology. Initial clinical trials are evalu-
are now used in the development of new and improved vac- ated, issues required for vaccine trials in developing countries
cines, in an attempt to move from traditional live viral and are addressed, clinical trials into Phase III and IV are evaluated,
bacterial vaccines to the theoretically ‘safer’ but ‘less immuno- ethical considerations are discussed, the economics of clinical
genic’ vaccines. The application of genetic and recombinant trials are mentioned, an industry perspective is given on the
Expert Review of Vaccines Downloaded from informahealthcare.com by 188.134.76.66 on 05/20/14
DNA approaches, protein production techniques and synthetic development of vaccines, and achieving global immunization
peptide chemistry has led to new and safer vaccines; however, is discussed. The paradigm of global alliance for vaccines and
there are still many obstacles for their clinical use. The limited immunization is nicely presented, followed by an economic
immunogenicity of many of these candidates has hindered their analysis of vaccine programs, US FDA licensing of vaccines,
development as potential vaccines for humans. Strategies to vaccine safety and manufacturing, and the work of the WHO is
enhance the immunogenicity of candidate vaccines have had analyzed. Efforts into the eradication of polio are discussed and
to be developed. recent immunological advances that impact vaccine development
are assessed.
Approaches to enhancing immunogenicity
Adjuvants have been developed that, when mixed with proteins, “...for a vaccine regime to be successful today, one
peptides or DNA, could amplify either or both the humoral needs to use new molecular and biological
For personal use only.
and cell-mediated immune responses to that antigen. The most techniques that have been developed in the last
frequently used adjuvant in experimental animals is complete 10 years – these techniques are useful in the
Freund’s adjuvant. Although very effective in evoking an effec-
generation of new and improved vaccines.”
tive and long-lasting immune response, complete Freund’s adju-
vant is not suitable for human use because it induces granulomas, This is followed by 23 chapters discussing the modulation of
fever and inflammation due to the oil and mycobacteria. There innate immunity, immunodominance of antigens, measurement
is only one registered human adjuvant (aluminium hydroxide or of T-cell responses, assessment of multivalent vaccines, vaccina-
aluminium phosphate) which is used in the diphtheria, tetanus tion and developing autoimmunity, adjuvants, Toll-like receptor
and hepatitis B vaccines. Aluminium salt adjuvants are limited agonists for enhanced immune responses, mucosal vaccines, nan-
in their use in that they preclude lyophilization or freezing, they oparticles, lipopeptide vaccines, use of dendritic cells to deliver
are not effective with all antigens and they do not stimulate vaccines, viral vectors, DNA vaccines, prime–boost approaches
cell-mediated immunity. Candidates for alternative adjuvants and transcutaneous vaccine delivery systems.
for vaccine development include: the Syntex formulation, SAF-1 The next 44 chapters discuss specific vaccines developed for
(containing squalene oil, an amino acid derivative of muramyl numerous diseases of bacterial and viral origin. These include
dipeptide [threonyl-MDP] and nonionic block polymers); the vaccines against meningococcus, influenza, Salmonella, cholera,
Ribi formulation (containing mycob acterial cell walls and TB, dengue, rotavirus, measles, HIV, hepatitis C, respiratory
monophosphoryl lipid A); and the saponin derivative, QS21 syncitial virus, cytomegalovirus, Epstein–Barr virus, herpes
(also called Quil A). The development of new adjuvants, how- simplex, rheumatic fever, Streptococcus, Shigella, Escherichia coli,
ever, has been dominated by concerns about safety, since most Staphylococcus aureus, Chlamydia trachomatis, malaria, Leish
of the adjuvants that have been developed to date are too toxic mania, schistosomiasis, Entamoeb histolytica, hookwom, small-
for use in humans. More recently, liposomes (phospholipid- pox, anthrax, tularemia, plague, Ebola and Marburg viruses, lassa
based vesicles) have been used to deliver antigens, in addition fever, hantavirus and SARS.
to the incorporation of antigens into solid particles such as The final five chapters touch on the development of cancer
immunostimulatory complexes. Other approaches for vaccine vaccines, including the approved vaccine against cervical can-
development include viral vectors, use of nanoparticles, tar- cer, vaccine development against Alzheimer’s and other neuro
geting antigens to receptors on dendritic cells and the use of degenerative diseases, and against autoimmune and chronic
Toll-like receptor ligands to enhance immunity to the antigen. inflammatory disorders. The final chapter discusses an interesting
The future holds promise for new vaccines to prevent, con- topic in the use of vaccines to treat drug addiction.
trol and possibly eradicate diseases, including cancer. All the Overall, the book addresses a range of important issues in
techniques described should lead to the production of new and the development of new-generation vaccines. It provides a solid
effective vaccines. overview of vaccine development and is greatly useful to a range
of target audiences, such as immunologists, molecular biologists, (Australia), and the Beauties and the Beast (Australia) for providing funding
chemists and investors in pharmaceutical companies who are directly to her laboratory for the development of breast cancer vaccines. The
interested in the development of new-generation vaccines. author has no other relevant affiliations or financial involvement with any
organization or entity with a financial interest in or financial conflict with
Financial & competing interests disclosure the subject matter or materials discussed in the manuscript apart from
Vasso Apostolopoulos would like to thank the Susan G Komen for Cure Breast those disclosed.
Cancer Foundation (USA), Bosom Buddies Breast Cancer Foundation No writing assistance was utilized in the production of this manuscript.
Expert Review of Vaccines Downloaded from informahealthcare.com by 188.134.76.66 on 05/20/14
For personal use only.
www.expert-reviews.com 553