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Vaccine. 2005 Mar 18;23(17-18):2115-20.

Do successful tuberculosis vaccines need to be immunoregulatory rather than merely Th1-boosting?

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Centre for Infectious Disease and International Health, University College London, Windeyer Institute of Medical Sciences, London W1T 4JF, UK.


Tuberculosis vaccine candidates are entering clinical studies in areas where BCG fails. This is a high-risk strategy. We suggest that geographical variation in the efficacy of BCG is related to the presence in developing countries of a cross-reactive background Th2-like response, probably attributable to exposure of mother and infant to helminths and environmental mycobacteria. Such Th2-like activity can stop Mycobacterium tuberculosis from being pushed into a latent state by the Th1 response, impair bactericidal functions and cause toxicity of TNF-alpha and pulmonary fibrosis. A successful vaccine, rather than driving a Th1 response, might need to suppress this pre-existing subversive Th2-like component.

[Indexed for MEDLINE]

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