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Nat Rev Immunol. 2005 Aug;5(8):661-7.

Immune responses to tuberculosis in developing countries: implications for new vaccines.

Author information

1
Centre for Infectious Diseases and International Health, Windeyer Institute for Medical Sciences, University College London, London W1T 4JF, UK. g.rook@ucl.ac.uk

Abstract

Tuberculosis is out of control in developing countries, where it is killing millions of people every year. In these areas, the present vaccine - Mycobacterium bovis bacillus Calmette-Guérin (BCG) - is failing. Progressive tuberculosis occurs because the potentially protective T helper 1 (T(H)1)-cell response is converted to an immunopathological response that fails to eliminate the bacteria. Here, we discuss the data indicating that the problem in developing countries is not a lack of adequate T(H)1-cell responses but, instead, an exaggerated tendency to switch to immunopathological responses. We propose that a successful vaccine needs to block this immunopathology, because it is not the quantity of T(H)1-cell activity that matters but, rather, its context.

PMID:
16056257
DOI:
10.1038/nri1666
[Indexed for MEDLINE]

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