ISCOMs: an adjuvant with multiple functions

Aluminum salts are currently the only widely used adjuvant for human vaccin es. Over the past 10-15 years, a large research effort has attempted to fin d novel adjuvants with ability to induce a broad range of immune responses, including cell-mediated immunity, The immunostimulating complex or ISCOM i s one adjuvant with multiple adjuvant properties, ISCOMs are open cage-like complexes typically with a diameter of about 40 win that are built up by c holesterol, lipid, immunogen, and saponins from the bark of the tree Quilla ia saponaria Molina. ISCOMs have been demonstrated to promote antibody resp onses and induce T helper cell as well as cytotoxic T lymphocyte responses in a variety of experimental animal models, and have now progressed to phas e I and II human trials, This review describes recent developments in the u nderstanding of the structure, composition, and preparation of ISCOMs and w ill cover important aspects of the understanding of the adjuvant functions of ISCOMs and how they act on the immune system.