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These include:[ref] Inflammatory cytokines (IL-1B, IL-33), which cause the release of IL-6, TNF, IL-8, and VEGF Heavy metals (aluminum, cadmium, mercury) Herbicides (atrazine, glyphosate) Pathogens (Lyme disease, lipopolysaccharides from bacteria, certain viruses, and mold spores) These triggers can cause a two-phase reaction : Immediately released mediators include histamine, TNF, tryptase, RANKL, and serotonin

Fan R, Sui J, Dong X, Jing B, Gao Z

Where efficacy studies have shown higher protection rates in cats vaccinated with adjuvanted vaccines versus non-adjuvanted vaccines, the former are preferable in cats at high risk of infection

Despite their popularity, there remains a paucity of human clinical evidence to support their safety and efficacy