Introduction
Dendritic cells (DCs), serve as pivotal antigen-presenting cells (APCs), bridge the innate and adaptive immune systems. Their specialized role lies in the processing and presentation of antigens to T cells, thereby orchestrating tailored T cell responses. 1 Equipped with an array of pattern-recognition receptors (PRRs), dendritic cells distinguish between “danger signals” and “safety signals,” which is crucial for initiating appropriate T-cell responses. Moreover, they adeptly integrate cues from the local tissue microenvironment to fine-tune T-cell responses. Under normal physiological conditions, dendritic cells play a vital role in maintaining immune homeostasis by activating T cells to eliminate infected or malignant cells, promoting regulatory T cells to mitigate chronic inflammation. Dysregulated immunity contributes to cancer development and tumor-induced immunosuppression including T-cell exhaustion, posing significant hurdles to cancer immunotherapy. Reinvigorating depleted T cells to stimulate anti-tumor responses represents a primary objective of current immunotherapeutic strategies. 2 The initiation and maintenance of robust T-cell responses hinge on effective antigen presentation by APCs, in which DCs are assumed to play a central role. Consequently, DC-based cancer vaccine strategies have gained increasing attention. 3 , 4 The burgeoning volume of research output in this domain underscores growing interest. However, a comprehensive exploration and analysis of the current status and emerging trends in dendritic cell-based vaccines remains lacking.
Bibliometrics stands as a widely embraced scientific approach for scrutinizing the current landscape of a specific research field, identifying hotspots, discerning trends, and evaluating publication quality. Through bibliometric analyses, researchers undertake both qualitative and quantitative examinations of publication and citation data within their respective fields over defined timeframes. 5 , 6 Among the databases employed for such analyses, the Web of Science Core Collection (WoSCC) emerges as the predominant choice. 7 In recent years, bibliometric methodologies have seen widespread adoption across diverse research domains and a plethora of studies documented. 8–10 , To date, no bibliometric studies of dendritic cell-based vaccines have been reported. In this investigation, we conduct a bibliometric analysis to comprehensively summarize hotspots and trends in dendritic cell-based vaccine research between 2009 and 2023 by using VOSviewer and CiteSpace software.
Materials and methods
Data collection
The exploration of the relevant literature centered around the theme “dendritic cell-based vaccines” was meticulously executed using the WoSCC Expanded database (Thomson Reuters, New York, USA). Our search spanned from January 1, 2009, to December 30, 2023. The article types were filtered to include “articles” and “reviews,” while articles in non-English languages were excluded. Figure 1 illustrates the article search process. Figure 1. Flowchart depicting the process of data collection and bibliometric analysis.

Data analysis
CiteSpace (version 5.8.R1) and VOSviewer (Leiden University, Leiden, The Netherlands) were employed for visual analyses and to generate maps and clusters. CiteSpace was utilized specifically for keyword analysis and to identify co-citation bursts. The analytical settings included time slicing (from 2009 to 2023), year per slice (1), selection criteria based on the g-index (k = 25), and no pruning. Within the co-citation literature graph, cluster labels were assigned using index terms and the log-likelihood ratio (LLR).
VOSviewer, another bibliometric software tool, was utilized to create knowledge maps based on web data and to visualize and explore these maps. In the network visualization map produced by VOSviewer, consistent colors denote the same clusters, and the size of nodes reflects the frequency of co-occurrence. Total Link Strength (TLS) represents the cumulative weight of connections between nodes and is visually represented by the width of links, reflecting collaboration strength. This study leveraged VOSviewer for country, institution, journal, author, citation, and keyword clustering due to its intuitive and clear performance in clustering tasks.
Employing Bradford’s nucleus, we determine core journals within the field. Additionally, we apply Lotka’s Law to analyze prolific authors and utilize the Hirsch index (h-index) to assess highly cited papers.
Results
Global publication volume and trend analysis
A total of 16,476 papers pertaining to dendritic cell-based vaccines between January 1, 2009, and December 30, 2023, were published globally. The predominant article types included original articles (12,242) and review articles (4,234). As depicted in Figure 2 , the annual publication volume on dendritic cell-based vaccines remained relatively stable, hovering around 1,000 papers over the past 15 years, indicating sustained research interest in this field. Figure 2. Temporal distribution of publications on dendritic cell-based vaccines from 2009 to 2023.


Country contributions to global publications
Over the past 15 y, a total of 129 countries have contributed to research on dendritic cell-based vaccines. Table 1 highlights the top 10 countries with the highest number of publications in this domain. United States leads the pack with 6,314 papers and 318,781 citations, followed by China (2,847 papers 70,301 citations) and Germany (1,068 papers 43,034 citations). Utilizing VOSviewer software, we visualized a collaborative network map among countries ( Figure 3 ), demonstrating the intensity of cooperation. The network map, comprising 20 countries, prominently features the United States, Germany, China, and Japan as major nodes, underscoring the close collaboration among nations. Notably, the United States exhibits the most extensive collaboration network, with a Total Link Strength (TLS) reaching 8,539,021, highlighting its leading position in this field. The collaboration intensity between the United States and China (TLS 13,619) emerges as the most robust, reflecting a particularly close collaboration. Figure 3. Vosviewer visualization of international collaboration among countries. Node size represents the number of publications, while link size indicates the strength of collaboration. Table 1. The top 10 countries according to total publications during 2009–2023. Rank Country Number of publications Proportion(%) Total citations Total link strength 1 The USA 6314 38.3% 318781 8539021 2 China 2847 17.2% 70301 4316814 3 Germany 1068 6.4% 43034 2183772 4 Japan 1003 6% 32307 1689116 5 England 874 5.3% 40764 1482922 6 France 870 5.2% 39056 1605125 7 Netherlands 761 4.6% 37086 1795448 8 Italy 659 3.9% 24798 1322027 9 Australia 650 3.9% 28382 1332072 10 South Korea 600 3.6% 16345 1078583


Table 1.
The top 10 countries according to total publications during 2009–2023.
| Rank | Country | Number of publications | Proportion(%) | Total citations | Total link strength |
| 1 | The USA | 6314 | 38.3% | 318781 | 8539021 |
| 2 | China | 2847 | 17.2% | 70301 | 4316814 |
| 3 | Germany | 1068 | 6.4% | 43034 | 2183772 |
| 4 | Japan | 1003 | 6% | 32307 | 1689116 |
| 5 | England | 874 | 5.3% | 40764 | 1482922 |
| 6 | France | 870 | 5.2% | 39056 | 1605125 |
| 7 | Netherlands | 761 | 4.6% | 37086 | 1795448 |
| 8 | Italy | 659 | 3.9% | 24798 | 1322027 |
| 9 | Australia | 650 | 3.9% | 28382 | 1332072 |
| 10 | South Korea | 600 | 3.6% | 16345 | 1078583 |
Analysis of institutions publishing on dendritic cell-based vaccine research
Table 2 presents the top 10 institutions ranked by the number of publications in the field. Emory University leads the list with 278 publications and a total citation count of 19,952, followed by the Chinese Academy of Sciences with 266 publications and 8,369 citations, and the University of Pittsburgh with 259 publications and 12,080 citations. Notably, the majority of the top 10 institutions hail from the United States. The collaboration network diagram among 18 institutions ( Figure 4 ) visually illustrates the degree of collaboration, with Emory University exhibiting the strongest collaborative ties with other institutions, boasting a Total Link Strength of 1,116. Figure 4. Visualization of institutional collaboration using VOSviewer. Node size corresponds to the number of publications, and link size reflects the intensity of collaboration. Table 2. The top 10 most productive institutions between 2009 and 2023. Rank The name of institution Publications Citations Location 1 Emory University 278 19952 The USA 2 Chinese Academy of Sciences 266 8369 China 3 University of Pittsburgh 259 12080 The USA 4 NIAID 247 14572 The USA 5 National Cancer Institute 234 10574 The USA 6 Harvard University 231 19716 The USA 7 INSERM 227 12749 French 8 Osaka University 225 9037 Japan 9 Duke University 213 13470 The USA 10 University of Washington 197 11185 The USA


Table 2.
The top 10 most productive institutions between 2009 and 2023.
| Rank | The name of institution | Publications | Citations | Location |
| 1 | Emory University | 278 | 19952 | The USA |
| 2 | Chinese Academy of Sciences | 266 | 8369 | China |
| 3 | University of Pittsburgh | 259 | 12080 | The USA |
| 4 | NIAID | 247 | 14572 | The USA |
| 5 | National Cancer Institute | 234 | 10574 | The USA |
| 6 | Harvard University | 231 | 19716 | The USA |
| 7 | INSERM | 227 | 12749 | French |
| 8 | Osaka University | 225 | 9037 | Japan |
| 9 | Duke University | 213 | 13470 | The USA |
| 10 | University of Washington | 197 | 11185 | The USA |
Analysis of top journals and co-cited journals
Visual analysis conducted using VOSviewer ( Figure 5 ) illustrates the collaborative network among the top 19 journals with the highest publication volumes on dendritic cell-based vaccines ( Figure 5a ) and the top 24 journals with the highest co-citation frequencies ( Figure 5b ). The top 10 journals with the most publications and co-citations in this domain are detailed in Table 3 . Frontiers in Immunology (IF = 7.3, 2023) leads with 782 publications, followed by Vaccine (IF = 5.5, 2023) with 756 papers, and PLoS One (IF = 3.7, 2023) with 532 papers. Notably, the Journal of Immunology (IF = 4.4, 2023) boasts the highest co-citation count at 69,029, followed by the Journal of Experimental Medicine (IF = 4.4, 2023) with 33,139 co-citations and Vaccine (IF = 5.5, 2023) with 33,139 co-citations, underscoring their authoritative influence through both publication and citation metrics. Figure 5. Graph illustrating collaboration among journals based on dendritic cell vaccine research using VOSviewer. Node size indicates the number of publications, while link size indicates the degree of collaboration intensity. Table 3. Top 10 prolific journals and co-cited journals on dendritic cell-based vaccine research from 2009 to 2023. Rank Journal Publications Citations IF* Co-cited journal Co-citations IF* 1 Frontiers in Immunology 782 22813 7.3 J Immunol 69029 4.4 2 Vaccine 756 21555 5.5 J Exp Med 33139 15.3 3 Plos One 532 14823 3.7 Vaccine 33025 5.5 4 Journal of Immunology 473 23233 4.4 J Virol 29849 5.4 5 Journal of Virology 302 11012 5.9 P Natl Acad Sci USA 29035 11.1 6 Vaccines 264 3130 5.5 Nature 26176 64.8 7 Cancer Immunology Immunotherapy 243 8311 5.8 Immunity 22565 4.1 8 Journal of Controlled Release 224 11325 10.8 Blood 21662 25.6 9 Biomaterials 184 10432 6.63 Science 20579 56.9 10 Human Vaccines & Immunotherapeutics 173 4456 4.8 Cancer Res 17901 11.2 Note : Abbreviation: IF*, impact factor.


Table 3.
Top 10 prolific journals and co-cited journals on dendritic cell-based vaccine research from 2009 to 2023.
Note : Abbreviation: IF*, impact factor.
| Rank | Journal | Publications | Citations | IF* | Co-cited journal | Co-citations | IF* |
| 1 | Frontiers in Immunology | 782 | 22813 | 7.3 | J Immunol | 69029 | 4.4 |
| 2 | Vaccine | 756 | 21555 | 5.5 | J Exp Med | 33139 | 15.3 |
| 3 | Plos One | 532 | 14823 | 3.7 | Vaccine | 33025 | 5.5 |
| 4 | Journal of Immunology | 473 | 23233 | 4.4 | J Virol | 29849 | 5.4 |
| 5 | Journal of Virology | 302 | 11012 | 5.9 | P Natl Acad Sci USA | 29035 | 11.1 |
| 6 | Vaccines | 264 | 3130 | 5.5 | Nature | 26176 | 64.8 |
| 7 | Cancer Immunology Immunotherapy | 243 | 8311 | 5.8 | Immunity | 22565 | 4.1 |
| 8 | Journal of Controlled Release | 224 | 11325 | 10.8 | Blood | 21662 | 25.6 |
| 9 | Biomaterials | 184 | 10432 | 6.63 | Science | 20579 | 56.9 |
| 10 | Human Vaccines & Immunotherapeutics | 173 | 4456 | 4.8 | Cancer Res | 17901 | 11.2 |
Analysis of main authors and co-cited authors in dendritic cell-based vaccine research
In the realm of dendritic cell-based vaccine research, a total of 67,765 authors have contributed to publications over the past 15 y. Table 4 presents the top 11 authors ranked by publication volume and co-citation count, representing influential figures and valuable collaborators in this field. Notably, Figdor, CG emerges as the most prolific author with 66 publications, followed by de Vries IJM ( n = 50) and Ishii, KJ ( n = 49). Co-cited authors, pivotal for their frequent citation in scholarly publications, serve as crucial indicators of academic contribution and influence. Banchereau, J ( n = 2,373), Steinman, RM ( n = 2,225), and Rosenberg, SA ( n = 1,490) top the list of co-cited authors. We utilized VOSviewer to visualize the collaborative relationships among authors ( Figure 6a ). Additionally, a visual analysis was conducted for co-cited authors, depicted in the network graph ( Figure 6b ), showcasing the top 20 authors with co-citation frequencies exceeding 631. Notably, the collaboration intensity between Banchereau, J and Steinman, RM is the most significant, with a total link strength of 1,204. Figure 6. Network diagram showcasing collaboration among authors (a) and coauthors (b) using VOSviewer. Node size represents the number of publications, and link size denotes the strength of collaboration. Table 4. Top 11 prolific authors and co-cited authors on dendritic cell-based vaccine research from 2009 to 2023. Rank Author Publications Citations Co-cited author Co-citations 1 Figdor, CG 66 4551 Banchereau, J 2373 2 de Vries IJM 64 3497 Steinman, RM 2225 3 Ishii, KJ 49 2825 Rosenberg, SA 1490 4 Pulendran, B 48 8029 Palucka, K 718 5 Kiyono, H 46 2184 Sallusto, F 997 6 Ossendorp, F 44 2724 Pulendran, B 966 7 Berneman, ZN 43 1994 Kawai, T 894 8 Kang, SM 42 1457 Sahin, U 835 9 Kunisawa, J 41 1278 Reddy, ST 806 10 Wang, B 41 592 Iwasaki, A 797 11 de Gruijl, TD 40 1024 Kantoff, PW 760


Table 4.
Top 11 prolific authors and co-cited authors on dendritic cell-based vaccine research from 2009 to 2023.
| Rank | Author | Publications | Citations | Co-cited author | Co-citations |
| 1 | Figdor, CG | 66 | 4551 | Banchereau, J | 2373 |
| 2 | de Vries IJM | 64 | 3497 | Steinman, RM | 2225 |
| 3 | Ishii, KJ | 49 | 2825 | Rosenberg, SA | 1490 |
| 4 | Pulendran, B | 48 | 8029 | Palucka, K | 718 |
| 5 | Kiyono, H | 46 | 2184 | Sallusto, F | 997 |
| 6 | Ossendorp, F | 44 | 2724 | Pulendran, B | 966 |
| 7 | Berneman, ZN | 43 | 1994 | Kawai, T | 894 |
| 8 | Kang, SM | 42 | 1457 | Sahin, U | 835 |
| 9 | Kunisawa, J | 41 | 1278 | Reddy, ST | 806 |
| 10 | Wang, B | 41 | 592 | Iwasaki, A | 797 |
| 11 | de Gruijl, TD | 40 | 1024 | Kantoff, PW | 760 |
Analysis of top co-cited references
Co-cited references, reflecting works frequently referenced together in publications, provide insights into pivotal contributions within a research field. Among 16,476 publications, a total of 430,221 co-cited references were identified. The top 11 co-cited references are delineated in Table 5 . The foremost among them is the seminal work by Banchereau, J. et al., published in Nature in 1998 ( n = 1173), elucidating “Dendritic cells and the control of immunity.” 11 Subsequently, Kantoff, P.W. et al.‘s article on “Sipuleucel-T Immunotherapy for Castration-Resistant Prostate Cancer,” 12 published in the New England Journal of Medicine in 2010, ranked second ( n = 614), followed by Hodi, F.S. et al.‘s contribution on “Improved Survival with Ipilimumab in Patients with Metastatic Melanoma” in the same journal ( n = 504). 13 A network diagram of the first 22 co-cited articles was generated using VOSviewer ( Figure 7a ), complemented by CiteSpace analysis to ascertain citation burst dynamics ( Figure 7b ), where the top 18 references with the most robust citation bursts, ranging from 2.75 to 4.81 in burst intensity, were highlighted. Notably, “mRNA vaccines – a new era in vaccinology” exhibited the highest burst value (4.41) post-2020, indicating its prominence in recent research discourse. 14 Figure 7. Analysis of co-cited references: (a) network visualization of co-citation references using VOS viewer. Larger nodes denote references with higher occurrences, while color similarity indicates close relationships. (b) Top 18 most frequently cited references, with red bars indicating burst duration and intensity reflecting the importance of the keyword to the research area. Table 5. Top 11 co-cited reference according to total publications on dendritic cell-based vaccine research from 2009 to 2023. Rank Co-cited reference Co-citations 1 banchereau j, 1998, nature, v392, p245, doi 10.1038/32588 1173 2 kantoff pw, 2010, new engl j med, v363, p411, doi 10.1056/nejmoa1001294 614 3 hodi fs, 2010, new engl j med, v363, p711, doi 10.1056/nejmoa1003466 504 4 banchereau j, 2000, annu rev immunol, v18, p767, doi 10.1146/annurev.immunol.18.1.767 501 5 palucka k, 2012, nat rev cancer, v12, p265, doi 10.1038/nrc3258 497 6 steinman rm, 2007, nature, v449, p419, doi 10.1038/nature06175 494 7 bachmann mf, 2010, nat rev immunol, v10, p787, doi 10.1038/nri2868 451 8 rosenberg sa, 2004, nat med, v10, p909, doi 10.1038/nm1100 450 9 coffman rl, 2010, immunity, v33, p492, doi 10.1016/j.immuni.2010.10.002 427 10 lutz mb, 1999, j immunol methods, v223, p77, doi 10.1016/s0022-1759(98)00204-x 405 11 manolova v, 2008, eur j immunol, v38, p1404, doi 10.1002/eji.200737984 388


Table 5.
Top 11 co-cited reference according to total publications on dendritic cell-based vaccine research from 2009 to 2023.
| Rank | Co-cited reference | Co-citations |
| 1 | banchereau j, 1998, nature, v392, p245, doi 10.1038/32588 | 1173 |
| 2 | kantoff pw, 2010, new engl j med, v363, p411, doi 10.1056/nejmoa1001294 | 614 |
| 3 | hodi fs, 2010, new engl j med, v363, p711, doi 10.1056/nejmoa1003466 | 504 |
| 4 | banchereau j, 2000, annu rev immunol, v18, p767, doi 10.1146/annurev.immunol.18.1.767 | 501 |
| 5 | palucka k, 2012, nat rev cancer, v12, p265, doi 10.1038/nrc3258 | 497 |
| 6 | steinman rm, 2007, nature, v449, p419, doi 10.1038/nature06175 | 494 |
| 7 | bachmann mf, 2010, nat rev immunol, v10, p787, doi 10.1038/nri2868 | 451 |
| 8 | rosenberg sa, 2004, nat med, v10, p909, doi 10.1038/nm1100 | 450 |
| 9 | coffman rl, 2010, immunity, v33, p492, doi 10.1016/j.immuni.2010.10.002 | 427 |
| 10 | lutz mb, 1999, j immunol methods, v223, p77, doi 10.1016/s0022-1759(98)00204-x | 405 |
| 11 | manolova v, 2008, eur j immunol, v38, p1404, doi 10.1002/eji.200737984 | 388 |
Analysis of high-frequency keywords
High-frequency keywords serve as markers for research hotspots and emerging trends within a field. Through co-occurrence network analysis using VOSviewer, keywords reflecting prominent research themes were identified ( Figure 8b ). Additionally, CiteSpace analysis facilitated the identification of keywords associated with the top 20 citation bursts, with red segments denoting the duration of these bursts ( Figure 8b ). Notably, nanoparticle, delivery, cancer vaccine, and clinical trial emerge as current focal points in research, as depicted in Figure 7 . Figure 8. Author keyword analysis: (a) Co-occurrence network of author keywords observed using VOSviewer. Larger nodes represent keywords with higher occurrences, and color similarity signifies close relationships. (b) Top 18 most frequently cited keywords, with red bars indicating burst duration and intensity reflecting the importance of the keyword to the research area.


Discussion
An in-depth bibliometric analysis was conducted to assess the current landscape and trends in dendritic cell-based vaccine research spanning from 2009 to 2023. The sustained interest observed in this domain underscores substantial research investment and the attainment of noteworthy scientific outcomes. Our findings serve as a valuable resource for researchers seeking to expedite topic selection, identify suitable collaborative partners and institutions, and stay abreast of global research frontiers.
There are mainly four types of DC vaccines with distinct characteristics and trends. Autologous DC vaccines are derived from patient’s monocytes of hematopoietic progenitor cells which is highly personalized for designing patient-specific neoantigen-based vaccines 15 but is also time-consuming. While allogeneic DC vaccines are easier to standardize and produce because of its healthy donor derivation. 16 There are also novel types like DCs loaded with tumor lysates and RNA or DNA-transfected DC vaccines. The former one provides a broader range of tumor antigens, especially in complex tumors with high mutational burdens and can be tailored to individual at the same time. 17 While the latter one allows for utilization of gene-editing technologies to improve DC function but still needs further confirmation. 18
The preeminence of the United States in dendritic cell-based vaccine research is apparent, reflected in its advanced research infrastructure, regulatory environment, numerous resources and clinical trials, and leadership in publication output. The U.S. possesses a well-established research infrastructure consisting numerous cancer institutions and universities. The U.S. Food and Drug Administration also offers a regulatory procedure for the development and approval of new regimens which ensured the quality of clinical translation. The mature and well-supported research ecosystem and substantial government funding like the National Institutes of Health have catalyzed robust extensive preclinical and clinical trials, boosting inter-country collaborations, particularly evident in the strong partnership between China and the United States, fostering transnational academic exchanges and driving progress in the field.
While the majority of the top 10 institutions by publication volume hail from the United States, one Chinese institution’s notable ranking underscores China’s increasing involvement. However, China still needs improvement in clinical translation due to its lack of consistency between research sites and flaws of trial design and execution. Although funding support from agencies like National Natural Science Foundation already exists, it is comprehensively less consistent and integrated compared to U.S. Considering that clinical trials existed, most of it conducted in China are in earlier stages, partly due to China’s large population that impact the progession of patient recruitment, data management and follow-up investigation. To enhance its research impact, China should bolster investment in infrastructure, standardize framework for drug and therapy approval, forge stronger partnerships with international institutes, and elevate its scientific influence. Notably, Emory University emerges as a frontrunner in total citations, reaffirming its authority in dendritic cell-based vaccine research.
Journal rankings shed light on publication patterns, with Frontiers in Immunology leading in paper quantity. Conversely, the Journal of Immunology claims the top spot in total citations. While Frontiers in Immunology boasts high publication volume, improvements in paper quality and research impact are warranted. Conversely, the Journal of Immunology stands as a paramount publication venue, serving as a cornerstone in the field. Awareness of these influential journals aids researchers in selecting appropriate outlets for manuscript submission, with top-ranked journals serving as authoritative representatives based on co-citation rankings.
Figdor, CG, De Vries IJM, and Ishii, KJ emerge as the foremost contributors in dendritic cell-based vaccine research, demonstrating exceptional scholarly impact. Figdor, CG’s focus on antigenic targeting across diverse dendritic cell subpopulations and their concurrent activation with adjuvants underscores innovative approaches to induce immunity. 19 , 20 De Vries IJM’s research endeavors center on enhancing the immunogenicity and efficacy of dendritic cell-based vaccines, reflecting a commitment to advancing vaccine technology. 21 , 22 Ishii, KJ’s notable contributions lie in the design and development of novel adjuvants for dendritic cell-based vaccines, indicative of pioneering efforts to bolster vaccine potency. 23 Additionally, Banchereau, J stands out as the most co-cited author, underscoring the profound influence of his seminal research in this field.
The article by Banchereau, J et al. entitled “Dendritic cells and the control of immunity” was the most cited paper, and it led to the recognition of dendritic cells as a powerful tool for immunity. 11 Post-2020, “mRNA vaccines – a new era in vaccinology” garners the highest citation rate, highlighting the transformative potential of mRNA vaccines in revolutionizing vaccine development. 14 With their notable efficacy, rapid development capabilities, cost-effectiveness, and safe delivery mechanisms, mRNA vaccines have emerged as a focal point in contemporary vaccine research, offering a promising alternative to conventional vaccine modalities.
Current hot keywords in dendritic cell-based vaccine research include cancer vaccine, nanoparticle, delivery, and clinical trial. The tumor microenvironment’s complexity, immune evasion, and tumor heterogeneity hinder immunotherapy efficacy. Traditional immunotherapy heightened patient responsiveness but leads to increased side effects, cost, and treatment duration, while cancer vaccines characterized by individual-specific treatment seems as a solution for eliminating adverse aspects.
Nanotechnology, particularly nanoparticles, exploits nanocarriers’ physicochemical properties, enhancing targeted tissue delivery for improved immunotherapy efficacy. Nanoparticles offer a large surface area for enhanced immune interaction and controlled release capabilities, enhancing clinical applications. Targeting dendritic cells shows promise in activating immune responses. Effective antigen and adjuvant delivery to dendritic cells is essential for stimulating adequate T-cell responses against cancer.
Nanoparticles as vaccine delivery systems offer superior immune efficacy due to several factors: (1) Triggering in situ tumor antigen release, enhancing immune response while loading antigens and adjuvants to efficiently activate DCs, and avoiding immune tolerance caused by immature DC phagocytosis of antigens. 24 , 25 (2) Improved immune response with simultaneous antigen and adjuvant loading, effectively activating DCs and avoiding immune tolerance. 26 (3) Better spatial and temporal vaccine delivery by controlling nanoparticle size, charge, and physicochemical characteristics, significantly improving lymph node (LN) accumulation. 27 (4) Different delivery modes including subcutaneous, intranasal, and oral administration, facing diverse immune environments. 28 (5) Nanomedicine platforms enabling precise and stable adjuvant delivery. 29
In addition to their role as delivery systems, nanoparticles possess the ability to elicit diverse immune responses and can serve as adjuvants for vaccines. 30 Nanoparticles offer promising potential as adjuvants for nanovaccines, bolstering immune responses and enhancing anti-tumor effects. Notably, superparamagnetic iron oxide nanoparticles (SPIO), which are renowned for its biocompatibility, find widespread application in medical imaging and drug delivery. 31 SPIO represents a standard formulation utilized in vaccine visualization studies, such as for labeling dendritic cells (DCs) to monitor their migration to the lymph nodes (LN). 32 There is speculation that SPIO may augment intracellular antigen delivery to antigen-presenting cells (APCs) through cross-presentation, thus harboring potential as a vaccine adjuvant. 33 Furthermore, the adjuvant effect of nanovaccines for cancer therapy has been associated with targeting toll-like receptors (TLRs), a prevalent adjuvant mechanism. Poly(γ-glutamic acid) (γ-PGA), a biocompatible polymer derived from Bacillus licheniformis and Bacillus subtilis, serves as an antigen carrier for cancer vaccines. 34 Studies by Yoshikawa et al. have illustrated the utility of γ-PGA nanoparticles as antigenic carriers for cancer vaccines. 35 Immunization of mice with ovalbumin (OVA) encapsulated in γ-PGA nanoparticles has been shown to activate cytotoxic T lymphocyte (CTL) responses and effectively retard tumor growth in mice without inducing toxicity. Moreover, in addition to their carrier role, γ-PGA nanoparticles activate DCs and elicit robust antigen-specific T-cell responses via Toll-like receptor 4 (TLR4) and MyD88-dependent signaling pathways, thereby bolstering both innate and adaptive immune responses, particularly cellular immunity. 36 Another notable advantage of γ-PGA nanoparticles is their potential for intranasal administration of antigen-encapsulated nanovaccines, hinting at the prospect of developing noninvasive cancer vaccines in the future. 37
Numerous papers detail dendritic cell-based vaccine outcomes in clinical trials across various diseases, as increasing researches showed that solid tumors like melanoma for its high immunogenicity 38 and hematological malignancies like leukemia 39 are best suited for DC vaccines. For instance, the renowned vaccine named Sipuleucel-T(provenge) has been approved by the FDA in 2010 for metastatic castration-resistant prostate cancer. 12 Beatriz M Carreno et.al directed DC vaccines on melanoma-encoded amino acid, which broadened the breadth and diversity of antigen, namely antitumor immunity. 40 A phase 2b trial of tumor lysate, particle loaded, dendritic cell (TLPLDC) vaccine conducted in stage III/IV melanoma patients showed improved OS and DFS. 41 David J Chung et al. found that triple antigen-bearing mRNA-electroporated autologous Langerhans-type dendritic cells vaccine combined with standard maintenance therapy for multiple myeloma induces antigen-specific immune reaction and proved its safety. 42 Sébastien Anguille and colleagues also showed that mRNA-electroporated DCs vaccinated patients with acute myeloid leukemia prevented or delayed relapse and improved OS. 43 A recent phase II trial of dendritic cell-based adjuvant immunotherapy in post-surgery malignant peritoneal mesothelioma patients showed safety, feasibility, and significantly prolonged survival. 44 Another phase 3 trial compared autologous dendritic cell-based immunotherapy with docetaxel and prednisone versus placebo in prostate cancer patients. Although well tolerated, it did not extend overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC). 45 A clinical trial combining dendritic cell immunotherapy (DCVAC/LuCa) with carboplatin/pemetrexed in advanced non-squamous non-small cell lung cancer patients demonstrated tolerability and favorable treatment outcomes in stage IV non-small cell lung cancer. 46 These trials suggest promising potential for dendritic cell-based vaccines in cancer immunotherapy. There are also insights into applying dendritic cell vaccines on ‘cold’ tumors like glioblastoma, but most of the clinical trials stuck in phase II and failed to meet the primary endpoint in phase III 47 due to lack of rigorous inclusion criteria. 48 The future direction lies in the bench-to-bed translation with regard to those clinical trials to benefit potential candidates.
Limitations
Our analysis of global dendritic cell-based vaccine trends covers literature from January 1, 2009, to December 30, 2023, excluding 2024 publications and possibly missing recent advancements. Limiting the study to English literature may introduce language bias. While WoSCC, a widely used scientometric database, was utilized, excluding articles not in WoSCC may introduce bias. Additionally, analyzing abstracts rather than full texts in VOSviewer may limit comprehensive information retrieval.
Conclusions
Overall, our study represents the inaugural comprehensive analysis of global trends in dendritic cell-based vaccine research. Due to its antigen selecting characteristics, DC vaccines are promising agents for personalization and combination therapies. The United States emerges as the primary driver of advancements in this field, demonstrating substantial leadership and contribution. Notably, the Journal of Immunology stands out as the most influential publication avenue within this domain. Authors Figdor, CG, De Vries IJM, and Ishii, KJ have emerged as pivotal contributors, showcasing significant contributions and serving as exemplary collaborators for researchers in this arena. Recent hot topics, including nanoparticle, delivery channel, cancer vaccine, and clinical trial, underscore the evolving landscape of research interests in this area. While research on dendritic cell-based vaccines displays strength, there remains ample room for further investment and exploration to advance our understanding and therapeutic potential in this crucial field.
Acknowledgments
We thank all the authors who participated in the dendritic cell-based vaccine study.
Author contributions
All authors contributed to the manuscript and approved the submitted version. L-Z: write the original draft. W-YH: modify the draft. Z-LC: figure preparation. L-JP: supervision and conceptualization. L-B: reviewed the manuscript.
Data availability statement
In this study, data sharing is not applicable as no new data were generated. The datasets utilized originated from publicly available resources: https://webofscience.clarivate.cn/wos/woscc/summary .
Disclosure statement
No potential conflict of interest was reported by the author(s).
The corresponding author brief
Dr Liu Bo currently serves in the Department of Neurosurgery at Xiangya Hospital, Central South University, Jiangxi. Dr Liu specializes in the clinical surgical treatment and research of nervous system tumors, cerebrovascular diseases, congenital nervous system disorders, and hydrocephalus. With extensive experience in diagnosing and treating these conditions, Dr Liu is dedicated to advancing clinical practices and research in neurosurgery, constantly exploring new treatment methods to improve patient quality of life and recovery outcomes.
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