Kurzfassung

Although standard vaccination approaches are effective in a considerable number of infectious diseases, vaccination strategies against tumors have only recently begun to prove successful and have led to FDA approval of sipuleucel-T for advanced prostate cancer as the first cancer vaccine with proven efficacy. In addition, also peptide-based vaccination approaches are effective, e. g. in renal cancer using GM-CSF as adjuvant. While classical prophylactic vaccination approaches are...Although standard vaccination approaches are effective in a considerable number of infectious diseases, vaccination strategies against tumors have only recently begun to prove successful and have led to FDA approval of sipuleucel-T for advanced prostate cancer as the first cancer vaccine with proven efficacy. In addition, also peptide-based vaccination approaches are effective, e. g. in renal cancer using GM-CSF as adjuvant. While classical prophylactic vaccination approaches are well suited for inducing protective antibody responses against virus infections, they may not be ideal for the induction of therapeutic T-cell responses. In this context, transcutaneous immunization (TCI) approaches are gaining increasing interest since they incorporate all desirable properties of an ideal cancer vaccine: in terms of defined antigen specificities, targeting of specific APC populations and well-defined adjuvants. Besides the advantage of self-medication, such easy-to-use vaccines lack the need for injections. In particular, needle-borne accidents may be circumvented, which represent a significant health burden due to needle-associated morbidity in both medical personnel and patients, a priority issue conceded by the WHO. Beyond this and more importantly, from an immunological point of view the skin is an attractive target for shaping immune responses: the delivery of antigens via the skin allows for the transcutaneous delivery of antigen plus adjuvant targeted to skin resident professional antigen-presenting cells (APC) eliciting potent adaptive immune responses as pioneered by Glenn and coworkers. While parental (subcutaneous or intramuscular) vaccine delivery systems are not well controlled in terms of drug release and targeting of specific immune organs, the drug dosage as well as targeting of skin draining lymph node areas in transcutaneous approaches can be easily and specifically achieved by the selection of skin areas or body regions.
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