Key recent advances in TB vaccine development and understanding of protective immune responses against mycobacterium tuberculosis
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Abstract
Tuberculosis is the leading infectious disease killer globally due to a single pathogen. Despite wide deployment of
standard drug regimens, modern diagnostics and a vaccine (bacille Calmette Guerin, BCG), the global tuberculosis epidemic is inadequately controlled. Novel, effective vaccine(s) are a crucial element of the World Health
Organization End TB Strategy. TB vaccine research and development has recently been catalysed by several
factors, including a revised strategy focused first on preventing pulmonary TB in adolescents and adults who are
the main source of transmission, and encouraging evaluations of novel efficacy endpoints. Renewed enthusiasm
for TB vaccine research has also been stimulated by recent preclinical and clinical advancements. These include
new insights into underlying protective immune responses, including potential roles for ‘trained’ innate immunity and Th1/Th17 CD4+ (and CD8+) T cells. The field has been further reinvigorated by two positive proof
of concept efficacy trials: one evaluating a potential new use of BCG in preventing high risk populations from
sustained Mycobacterium tuberculosis infection and the second evaluating a novel, adjuvanted, recombinant
protein vaccine candidate (M72/AS01E) for prevention of disease in adults already infected. Fourteen additional
candidates are currently in various phases of clinical evaluation and multiple approaches to next generation
vaccines are in discovery and preclinical development. The two positive efficacy trials and recent studies in
nonhuman primates have enabled the first opportunities to discover candidate vaccine-induced correlates of
protection, an effort being undertaken by a broad research consortium.
Link to resource
https://doi.org/10.1016/j.smim.2020.101431Collections
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