The current status, challenges, and future developments of new tuberculosis vaccines

Abstract

Mycobacterium tuberculosis complex causes tuberculosis (TB), one of the top 10 causes of death worldwide. TB results in more fatalities than multi-drug resistant (MDR) HIV strain related coinfection. Vaccines play a key role in the prevention and control of infectious diseases. Unfortunately, the only licensed preventive vaccine against TB, bacilli Calmette-Guérin (BCG), is ineffective for prevention of pulmonary TB in adults. Therefore, it is very important to develop novel vaccines for TB prevention and control. This literature review provides an overview of the innate and adaptive immune response during M. tuberculosis infection, and presents current developments and challenges to novel TB vaccines. A comprehensive understanding of vaccines in preclinical and clinical studies provides extensive insight for the development of safer and more efficient vaccines, and may inspire new ideas for TB prevention and treatment.

The role of vaccines in fighting antimicrobial resistance (AMR)

“…Many M tuberculosis vaccine approaches have been evaluated 72-74 and as of today, none have been successful. Recent extensive studies into the immunophysiology of TB associated granulomas have shed new light on what could be considered a protective response.…”

Animal Models of Tuberculosis Vaccine Research: An Important Component in the Fight against Tuberculosis

“…Currently, 22 new TB vaccines are being evaluated in clinical trials, four of which [Vaccae (Mycobacterium vaccae for injection) in patients with latent TB infection (LTBI), Mycobacterium indicus pranii (MIP)/Mw, Utilins (Mycobacterium phlei), and VPM1002 (rBCG ΔureC::hly)] have reached Phase III clinical trials [2][3][4]. Furthermore, three therapeutic vaccines [Vaccae, Utilins, and BCG Polysaccharide and Nucleic Acid Injection (BCG-PSN)] have obtained registration certi cates from the China Food and Drug Administration (http://eng.sfda.gov.cn/WS03/ CL0755/) and have been widely used to clinically treat TB in China [4]. In comparison with TB vaccines at the stage of clinical trials, there are many more vaccine candidates emerging in preclinical stages of development.…”

Challenges of Immune Response Diversity in the Human Population Concerning New Tuberculosis Diagnostics, Therapies, and Vaccines

“…Genetic variability between individuals also poses a challenge to developing a universal TB vaccine (Gong et al, 2018). Substantial variability in response to the current BCG vaccine is attributed to individual differences in age, sex, dosage, method of vaccination, and nutritional status, among others (Castiblanco and Anaya, 2015;Newport, 2015).…”