铝化合物（明矾）是兽医和人类疫苗中使用最广泛的佐剂。最初认为明矾仅仅是一种简单的抗原储存仓，但近几十年来我们对其作用机制的理解有了重大进步。尽管如此，在免疫调节的不同方面，关于其作用的共识尚未达成，明矾仍然是疫苗学领域长期研究的课题。该综述按时间顺序讨论了在大多数未能解释明矾作用机制的企图中提出的各种假说，从仅仅是储存理论到涉及NLRP3炎症小体，并从细胞死亡相关的危险因素到结晶结构介导的质膜变化。此外，还探讨了慢性感染患者单纯使用明矾注射治疗可意外地减少乙型肝炎病毒（HBV）的病毒载量和HBeAg血清转换，并在实验小鼠中显著抑制肿瘤的新发现，揭示了明矾在抗原制备以外的潜在临床应用。随着源自自然或人为的新兴微生物的威胁日益增加，这些微生物在人口规模上对健康构成重大威胁，因此讨论了明矾作为“急救”疫苗的潜在用途。

Aluminum compounds (alum) are the most widely used adjuvants in veterinary and human vaccines. Alum was initially thought to be a simple depot for antigen retention; however, our understanding of the mechanism by which it works has progressed substantially in recent decades. Nonetheless, consensus regarding its roles in different aspects of immune regulation has not been reached, and it remains a long-standing research subject in the field of vaccinology. This review, in chronological order, discusses the various hypotheses proposed in mostly inadequate attempts to illuminate the mechanism by which alum works, from the depot theory to the involvement of the NLRP3 inflammasome and from cell death-associated danger factors to crystalline structure-mediated plasma membrane alteration. In addition, novel findings of unexpected beneficial effects of decreased HBV (Hepatitis B virus) viral load and HBeAg seroconversion in chronically infected patients, as well as significant tumor suppression in experimental mice following multiple alum-only injections are examined, revealing alum's potential clinical applications beyond its use as a simple tool in antigen preparation. With increasing threats of emerging microbes, originating from natural or man-made sources, that pose significant health concerns at the population scale, the potential use of alum as a 'first-aid' vaccine is also discussed.