Vaccines are some of the most effective tools for the prevention of infectious diseases. Adjuvants are included in vaccines for a variety of reasons: to increase the breadth of response, to lower antigen dose, to overcome limited immune response in some populations, or to enable complex combination vaccines. This study aims to review the safety of licensed vaccine adjuvants and describe their mechanism of action. Potential publications for inclusion were identified through a direct search of PubMed/Medline database. Results of online literature searches were supplemented by relevant papers cited in published studies along with the authors knowledge of published studies. To date, there are 5 licensed vaccine adjuvants in US and Europe: Aluminum salts (EU, US), MF59 (EU), AS03 (EU), AS04 (EU, US), and virosomes (EU). AS03 is not available as an adjuvant in other vaccines but included within the US governments National Stockpile. All vaccines that contain these adjuvants have been proven safe in clinical trials and post-marketing studies, with the exception of the AS03, for which the rare events of narcolepsy have been reported in some countries. Every adjuvant has a complex and often multifactorial immunological mechanism, usually poorly understood in vivo. The safety profile of an adjuvant, including the actual and hypothetical risks, is a critical component that can speed up or impede adjuvant development. The increasing understanding in adjuvant sciences is fundamental to the further development of new adjuvants.Rambe et al., International Current Pharmaceutical Journal, July 2015, 4(8): 420-431
Background: Obesity with knee osteoarthritis (OA) is related to chronic pain causing physical inactivity that leads to decreased cardiorespiratory endurance and quality of life. Aquatic and land-based exercises are effective in improving physical activity. The aim of this study is to compare between aquatic and land-based exercise to improve cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis.Methods: A single-blind, randomized, controlled trial was conducted on thirty-three obese patients with knee OA who visited Obesity Clinic of Medical Rehabilitation Cipto Mangunkusumo Hospital, from October 2016 to January 2017, subjects were divided into aquatic or land-based exercise group. Aerobic and knee-strengthening exercises were given. Cardiorespiratory endurance was assessed using the Borg Scale, whereas both the BORG CR-10 and SF-36 questionnaires were used to assess quality of life.Results: After intervention, there were significant improvements in the land-based exercise group in the rating of perceived exertion (p=0.02), role limitations due to physical health (p=0.024), role limitations due to emotional problems (p=0.041), energy/fatigue (p=0.016), and the decline in pain (p=0.049) parameters. While in the aquatic exercise, there were significant improvements in leg fatigue (p=0.016), energy/fatigue (p=0.025), emotional well-being (p<0.001), and general health (p=0.045) parameters. Despite this, there were no significant differences between two groups regarding cardiorespiratory endurance and quality of life.Conclusion: This study found that patients could start aquatic exercise to reduce leg fatigue and enhance general health and energy. After that, exercise could be continued in land-based settings to improve cardiorespiratory endurance and quality of life.
Since the initial reports of a link between Zika and microcephaly, researchers across the world began working toward understanding the virus. In a short amount of time, Zika has become a household name, prompting worldwide concern. The virus is spread rapidly by mosquito bites. We currently do not have a vaccine for Zika. But with the recent findings, vaccine companies are mobilizing their resources to expedite efforts to shave years off the typical decade-long process of vaccine development.
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