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Tuberculosis vaccines: Opportunities and challenges
Author(s) -
Zhu Bingdong,
Dockrell Hazel M.,
Ottenhoff Tom H.M.,
Evans Thomas G.,
Zhang Ying
Publication year - 2018
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13245
Subject(s) - medicine , tuberculosis , intensive care medicine , virology , immunology , environmental health , pathology
Tuberculosis (TB) is a serious disease around the world. Bacillus Calmette–Guérin (BCG) is the only TB vaccine licensed for use in human beings, and is effective in protecting infants and children against severe miliary and meningeal TB. However, BCG's protective efficacy is variable in adults. Novel TB vaccine candidates being developed include whole‐cell vaccines (recombinant BCG (rBCG), attenuated Mycobacterium tuberculosis , killed M. tuberculosis or Mycobacterium vaccae ), adjuvanted protein subunit vaccines, viral vector‐delivered subunit vaccines, plasmid DNA vaccines, RNA‐based vaccines etc. At least 12 novel TB vaccine candidates are now in clinical trials, including killed M. vaccae , rBCG ΔureC::hly , adjuvanted fusion proteins M72 and H56 and viral vectored MVA85A. Unfortunately, in TB, there are no correlates of vaccine‐induced protection, although cell‐mediated immune responses such as interferon‐gamma (IFN‐γ) production are widely used to assess vaccine's immunogenicity. Recent studies suggested that central memory T cells and local secreted IgA correlated with protection against TB disease. Clinical TB vaccine efficacy trials should invest in identifying correlates of protection, and evaluate new TB biomarkers emerging from human and animal studies. Accumulating new knowledge on M. tuberculosis antigens and immune profiles correlating with protection or disease risk will be of great help in designing next generation of TB vaccines.