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Adjuvant

In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. In this sense, they are very roughly analogous with chemical catalysts.

Inhaltsverzeichnis

1 Pharmacology
2 Immunology
3 Oncology
4 Other uses
5 References
6 See also

Pharmacology

In pharmacology, adjuvants are drugs that have few or no pharmacological effects by themselves, but may increase the efficacyor potencyof other drugs when given at the same time.

For instance, caffeinehas minimal analgesiceffect on its own, but may have an adjuvant effect when given with paracetamol.

Immunology

Similarly, in immunologyan adjuvant is an agent which, while not having any specific antigeniceffect in itself, may stimulate the immune system, increasing the response to a vaccine. Aluminum salts are used in some human vaccines ^{[{{fullurl:Template:FULLPAGENAME}}#endnote_aluminum]}. The compound QS21is under investigation as a possible immunological adjuvant^{[{{fullurl:Template:FULLPAGENAME}}#endnote_Quil]} as is Chiron?s MF59 ^{[{{fullurl:Template:FULLPAGENAME}}#endnote_MF59]}.

Oncology

The terms adjuvant and neoadjuvant have special meanings in oncology. Adjuvant therapy refers to additional treatment, usually given after surgery where all detectable disease has been removed, but where there remains a statistical risk of relapse due to occult disease. If known disease is left behind following surgery, then further treatment is not technically "adjuvant".

For example, radiotherapyor chemotherapyare commonly given as adjuvant treatments after surgery for a breast cancer. Oncologists use statistical evidence to assess the risk of disease relapse before deciding on the specific adjuvant therapy. The aim of adjuvant treatment is to improve disease-specific and overall survival. Because the treatment is essentially for a risk, rather than for provable disease, it is accepted that a proportion of patients who receive adjuvant therapy will already have been cured by their primary surgery.

Adjuvant chemotherapy is often given following surgery for colon cancer, and also following surgery for lung cancer. Adjuvant radiotherapy may be given following surgery for a number of different cancers, notably breast, prostate, and some gynaecological cancers.

Neoadjuvant therapy, in contrast to adjuvant therapy, is given before the main treatment. For example, chemotherapy that is given before removal of a breast is considered neoadjuvant chemotherapy.

Other uses

The term adjuvant was also adopted by visionary thinker Buckminster Fullerto describe Kiyoshi Kuromiya, who served as a writing partner for several books, including Critical Path, and the post-humously published Cosmography. Fuller chose that word very deliberately to describe the unique role that Kiyoshi had played in his last publications which he wished to acknowledge was a very active one. Fuller's usage comes from the dictionary's definition as "serving to aid or contribute; one that helps or facilitates."

References

^ "Aluminum salts in vaccines--US perspective" by N. W. Baylor, W. Egan and P. Richman (2002) Vaccine Volume 20 Suppl 3, pages S18-23. Entrez PubMed12184360
^ "Prototype Alzheimer's disease epitope vaccine induced strong Th2-type anti-Abeta antibody response with Alum to Quil A adjuvant switch" by A. Ghochikyan, M. Mkrtichyan, I. Petrushina, N. Movsesyan, A. Karapetyan, D. H. Cribbs and M. G. Agadjanyan (2005) Vaccine online December 5, 2005 ahead of print publication. Entrez PubMed16368167
^ NIH"Chiron Corporation will produce the H9N2vaccineat its manufacturing facility in Siena, Italy. The company will prepare different dosages of the vaccine, which is based on an inactivated strain of the H9N2 virus developed by the Centers for Disease Control and Prevention. Some dosages will contain Chiron?s MF59 adjuvant?a substance designed to boost the vaccine?s protective effect."