Aluminum-containing adjuvants continue to be the most widely used adjuvants for human use. In the last year a major breakthrough has been the realization that alum adjuvant triggers an ancient pathway of innate recognition of crystals in monocytes and triggers them to become immunogenic dendritic cells, nature's adjuvant. This recognition can occur directly, via the triggering of the NALP3 inflammasome by alum crystals, or indirectly through release of the endogenous danger signal uric acid. It is also clear now that adjuvants trigger the stromal cells at the site of injection, leading to the necessary chemokines that attract the innate immune cells to the site of injection. How exactly these pathways interact remains to be determined.

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Keywords Th2 cell, adjuvant, aluminum, aluminum hydroxide, aluminum hydroxycarbonate, aluminum hydroxyphosphate, aluminum oxyhydroxide, aluminum phosphate, aluminum potassium sulfate, as 02; as3, chemokine, cryopyrin, dendritic cell, dipalmitoylphosphatidylethanolamine, drug mechanism, human, hydroxide, immune response, immunocompetent cell, immunostimulating agent, in vivo study, injection site, innate immunity, nonhuman, qs 21, review, stroma cell, unclassified drug, uric acid, vaccine
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Journal Current Opinion in Immunology
Lambrecht, B.N.M, Kool, M, Willart, M.A, & Hammad, H. (2009). Mechanism of action of clinically approved adjuvants. Current Opinion in Immunology (Vol. 21, pp. 23–29). doi:10.1016/j.coi.2009.01.004