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Journal Of Experimental Medicine • April 2008<br />

Alum adjuvant<br />

boosts adaptive immunity<br />

by inducing uric acid and activating<br />

inflammatory dendritic cells<br />

Kool M1, Soullié T, van Nimwegen M,<br />

Willart MA, Muskens F, Jung S, Hoogsteden HC,<br />

Hammad H, Lambrecht BN.<br />

Department of Pulmonary Medicine<br />

Erasmus University Medical Centre<br />

3015 GD Rotterdam, Netherlands<br />

Abstract<br />

Alum (aluminum hydroxide) is the most widely used adjuvant in human<br />

vaccines, but the mechanism of its adjuvanticity remains unknown. In<br />

vitro studies showed no stimulatory effects on dendritic cells (DCs). In<br />

the absence of adjuvant, Ag was taken up by lymph node (LN)-resident<br />

DCs that acquired soluble Ag via afferent lymphatics, whereas after injection<br />

of alum, Ag was taken up, processed, and presented by inflammatory<br />

monocytes that migrated from the peritoneum, thus becoming<br />

inflammatory DCs that induced a persistent Th2 response. The enhancing<br />

effects of alum on both cellular and humoral immunity were completely<br />

abolished when CD11c(+) monocytes and DCs were conditionally depleted<br />

during immunization. Mechanistically, DC-driven responses were<br />

abolished in MyD88-deficient mice and after uricase treatment, implying<br />

the induction of uric acid. These findings suggest that alum adjuvant is<br />

immunogenic by exploiting “nature’s adjuvant,” the inflammatory DC<br />

through induction of the endogenous danger signal uric acid.<br />

“Alum (aluminum hydroxide)<br />

is the most widely used adjuvant<br />

in human vaccines, but the mechanism<br />

of its adjuvanticity remains unknown.”<br />

http://www.ncbi.nlm.nih.gov/pubmed/?term=18362170

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