Immunological adjuvants: desirable properties and side-effects.

Adjuvants can be used with recombinant antigens to elicit cell-mediated immunity and antibodies of protective isotypes (IgG2a in the mouse and IgG1 in primates). Adjuvants should not produce reactions at injection sites, be pyrogenic or induce anterior uveitis or arthritis. Among 130 analogs of muramyl dipeptides tested, N-acetylmuramyl-L-threonyl-D-isoglutamine showed the greatest separation of potency as an adjuvant from potency in the production of side-effects. A stable emulsion of squalane and the Pluronic polymer L-121 provides a versatile vehicle for targeting of antigens to antigen-presenting cells. The combination of this emulsion with the threonyl analog of MDP is termed Syntex Adjuvant Formulation. This formulation increases the efficacy of influenza, hepatitis B virus, herpes simplex virus, lentivirus and tumor vaccines in experimental animals.