Adjuvants are a diverse family of substances whose main objective is to increase the strength, quality, and duration of the immune response caused by vaccines. The most commonly used adjuvants are aluminum-based, oil-water emulsion, and bacterial-origin adjuvants. In this paper, we will discuss how the election of adjuvants is important for the adjuvant-mediated induction of immunity for different types of vaccines. Aluminum-based adjuvants are the most commonly used, the safest, and have the best efficacy, due to the triggering of a strong humoral response, albeit generating a weak induction of cell-mediated immune response. Freund’s adjuvant is the most widely used oil-water emulsion adjuvant in animal trials; it stimulates inflammation and causes aggregation and precipitation of soluble protein antigens that facilitate the uptake by antigen-presenting cells (APCs). Adjuvants of bacterial origin, such as flagellin, E. coli membranes, and monophosphoryl lipid A (MLA), are known to potentiate immune responses, but their safety and risks are the main concern of their clinical use. This minireview summarizes the mechanisms that classic and novel adjuvants produce to stimulate immune responses.

Spinal cord injuries have a multifactorial process with diverse evolution over time. An acute injury produces severe pathological and physiological changes in the organism, homeostasis is recovered, and both adverse and favorable reactions occur for the individual. In this chapter, we describe the pathophysiological follow-up to spinal cord injuries, from their acute to chronic presentations. The importance of this knowledge lies in finding solutions to the multiple disorders generated from a spinal cord injury. These will depend on the specific needs of each stage, considering the intensity of the injury, and the time elapsed from the beginning of the process until years later.