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Trends Immunol. 2014 Aug;35(8):387-95. doi: 10.1016/j.it.2014.04.006. Epub 2014 May 27.

Tuberculosis vaccines--rethinking the current paradigm.

Author information

1
Statens Serum Institut, Department of Infectious Disease Immunology, Artillerivej 5, 2300 Copenhagen S, Denmark. Electronic address: pa@ssi.dk.
2
Statens Serum Institut, Department of Infectious Disease Immunology, Artillerivej 5, 2300 Copenhagen S, Denmark.

Abstract

The vaccine discovery paradigm in tuberculosis (TB) has been to mimic the natural immune response to infection. With an emphasis on interferon (IFN)-γ as the main protective cytokine, researchers have selected dominant antigens and administered them in delivery systems to promote strong T helper (Th)1 responses. However, the Bacillus Calmette-Guérin (BCG) vaccine is a strong inducer of Th1 cells, yet has limited protection in adults, and further boosting by the Modified-Vaccinia-Ankara (MVA)85A vaccine failed to enhance efficacy in a clinical trial. We review the current understanding of host-pathogen interactions in TB infection and propose that rather than boosting Th1 responses, we should focus on understanding protective immune responses that are lacking or insufficiently promoted by BCG that can intervene at critical stages of the TB life cycle.

KEYWORDS:

BCG; Th1; interferon gamma; mycobacteria; tuberculosis; vaccine

PMID:
24875637
DOI:
10.1016/j.it.2014.04.006
[Indexed for MEDLINE]

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