New Vaccines against Tuberculosis

MARTIN C; BIGI F; GICQUEL B

Tuberculosis 2007

Flying Publisher

Año: 2007; p. 341 - 356

The current vaccine against tuberculosis (TB), bacille Calmette-Guérin (BCG), is a live vaccine derived from an attenuated strain of Mycobacterium bovis. BCG protects against severe childhood forms of the disease, but fails to protect against adult pulmonary TB in countries in which it is endemic. For more than 80 years, no new TB vaccine has successfully been developed. With TB eradication on the horizon, new vaccines with better protection than BCG are urgently needed. The development of an effective TB vaccine seemed impossible until only a few years ago. In the last ten years of work with experimental laboratory models, many vaccine candidates have been developed. They include protein or DNA-subunit vaccines, modified BCG, and attenuated Mycobacterium tuberculosis. Some of these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. against severe childhood forms of the disease, but fails to protect against adult pulmonary TB in countries in which it is endemic. For more than 80 years, no new TB vaccine has successfully been developed. With TB eradication on the horizon, new vaccines with better protection than BCG are urgently needed. The development of an effective TB vaccine seemed impossible until only a few years ago. In the last ten years of work with experimental laboratory models, many vaccine candidates have been developed. They include protein or DNA-subunit vaccines, modified BCG, and attenuated Mycobacterium tuberculosis. Some of these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. Mycobacterium bovis. BCG protects against severe childhood forms of the disease, but fails to protect against adult pulmonary TB in countries in which it is endemic. For more than 80 years, no new TB vaccine has successfully been developed. With TB eradication on the horizon, new vaccines with better protection than BCG are urgently needed. The development of an effective TB vaccine seemed impossible until only a few years ago. In the last ten years of work with experimental laboratory models, many vaccine candidates have been developed. They include protein or DNA-subunit vaccines, modified BCG, and attenuated Mycobacterium tuberculosis. Some of these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. Mycobacterium tuberculosis. Some of these candidates are now being tested for safety and immunogenicity in human volunteers. For the first time, Phase I clinical trials of new TB vaccine candidates have started. Many of these new trials involve recombinant BCG or improved BCG immunity by boosting with vaccines consisting of subunits or attenuated Vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected: they include those vaccinated with BCG, and those infected with M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines. M. tuberculosis or with HIV. The goal is a new generation of vaccines effective against the transmissible respiratory forms of TB. Good candidate vaccines able to boost BCG, thereby improving protection, could be a reality in the short term. The second step is to obtain a new generation of vaccines able to replace the currently used BCG and make the eradication of TB feasible. These new vaccines can be expected in the middle term, and live vaccines are reliable and promising candidates. Indeed, these ultimate goals may require safe live vaccines.