Again, the observation that the vaccine was highly immunogenic and could induce a strong Th1 response [10, 26] led to the use of the formulation

as an immunological stimulus for the successful treatment of patients with persistent PKDL [11]. Despite these satisfactory results, to our knowledge, such a formulation has not been examined for its efficacy in trials against VL. Herein we observed that alum + LAg failed to protect BALB/c mice against challenge with L. donovani. We therefore envisage that inclusion of a second Th1 promoting adjuvant such as IL-12 or BCG with alum will be necessary for an alum containing vaccine to be clinically successful against both CL and VL [8, 9]. Nonetheless, it must be considered that failure of alum-ALM + BCG to protect susceptible BALB/c against L. major[27] raises click here some concern about the similar use of such an adjuvant in humans. Saponin remains the immunopotentiator of choice in many cancer and infectious disease vaccine trials, such as malaria, HIV, hepatitis learn more and tuberculosis [12]. In experimental VL

FML or the immunodominant leishmanial antigen (NH36) formulated with saponin was found to be effective when administered prophylactically [13, 28], and furthermore such formulations were also found to be efficacious when utilized immunotherapeutically [14, 16]. These results facilitated the development of the currently licensed vaccine Leishmune®, composed of FML with increased amounts of saponin for field trials Pyruvate dehydrogenase against canine VL. Indeed, Leishmune® has been recently shown immunotherapeutic potential for vaccination against canine VL [17]. In contrast to these reports, our study showed that saponin + LAg immunization not only failed to reduce parasite burden in liver of L. donovani challenged mice but also caused exacerbation of infection in spleen. These

findings are partly in keeping with those of Grenfell et al., who observed that antigenic extracts of L. amazonensis or L. braziliensis in association with saponin conferred only partial protection against L. chagasi[29]. Thus, the efficacy of saponin with leishmanial antigens other than FML may vary, and such observations warrant further pre-clinical studies to establish the potential of saponin to adjuvant vaccines against leishmaniasis. Hypergammaglobulinemia and non-specific polyclonal antibody responses are hallmarks of VL. However, vaccine-induced antigen specific humoral response and their isotype profiles are often used as convenient surrogate markers of Th1 and Th2 response [21]. Evidence from both human patients and mice indicate that B-cell activation and production of polyclonal IgG may contribute to disease pathogenesis, leading to exacerbation of disease [19, 20]. The absence of a detectable non-specific IgG response in mice immunized with alum + LAg and saponin + LAg suggests that polyclonal antibody responses do not contribute to the failure of protection in our system.