Chambers M A, Williams A, Gavier-Widén D, Whelan A, Hall G, Marsh P D, Bloom B R, Jacobs W R, Hewinson R G
TB Research Group, Department of Bacterial Diseases, Veterinary Laboratories Agency Weybridge, New Haw, Addlestone, Surrey KT15 3NB.
Infect Immun. 2000 Dec;68(12):7094-9. doi: 10.1128/IAI.68.12.7094-7099.2000.
Tuberculosis remains one of the most significant diseases of humans and animals. The only currently available vaccine against this disease is a live, attenuated vaccine, bacillus Calmette-Guérin (BCG), which was originally derived from Mycobacterium bovis and despite its variable efficacy is the most widely administered vaccine in the world. With the advent of the human immunodeficiency virus-AIDS pandemic concern has been raised over the safety of BCG. Moreover, since BCG sensitizes vaccinated individuals to the tuberculin test, vaccination with BCG prevents diagnosis of infection in vaccinated individuals. Recently, auxotrophic strains of BCG have been generated by insertional mutagenesis which have been shown to be safer than the parent BCG strain following administration to mice with severe combined immunodeficiency disease. These strains have also been shown to give comparable protection against intravenous and intratracheal challenge of BALB/c mice with M. tuberculosis relative to conventional BCG. Here we report that one of these mutants, a leucine auxotroph of BCG, conferred significant protection of the lungs and spleens of guinea pigs infected with M. bovis and protection of the spleens of guinea pigs infected with M. tuberculosis in the absence of a cutaneous hypersensitivity reaction to tuberculin. Therefore, protective immunity to tuberculosis may, at least in part, be achieved without sensitization to the tuberculin skin test. These results indicate that it may be possible to develop a new generation of vaccines based on BCG that are protective, are safe for use in the immunocompromised, and do not preclude the use of the tuberculin skin test in both humans and animals.
结核病仍然是人类和动物最重要的疾病之一。目前唯一可用于预防这种疾病的疫苗是减毒活疫苗卡介苗(BCG),它最初源自牛分枝杆菌,尽管其效力不一,但却是世界上使用最广泛的疫苗。随着人类免疫缺陷病毒——艾滋病大流行的出现,人们对卡介苗的安全性产生了担忧。此外,由于卡介苗会使接种疫苗的个体对结核菌素试验产生致敏反应,因此接种卡介苗会妨碍对已接种个体感染情况的诊断。最近,通过插入诱变产生了卡介苗的营养缺陷型菌株,在给患有严重联合免疫缺陷疾病的小鼠接种后,这些菌株已被证明比亲本卡介苗菌株更安全。相对于传统卡介苗,这些菌株在保护BALB/c小鼠抵抗结核分枝杆菌的静脉内和气管内攻击方面也表现出相当的保护作用。在此我们报告,这些突变体之一,即卡介苗的亮氨酸营养缺陷型,在对结核菌素无皮肤过敏反应的情况下,对感染牛分枝杆菌的豚鼠的肺和脾提供了显著保护,对感染结核分枝杆菌的豚鼠的脾也提供了保护。因此,对结核病的保护性免疫至少在一定程度上可以在不对结核菌素皮肤试验产生致敏的情况下实现。这些结果表明,有可能开发出新一代基于卡介苗的疫苗,这些疫苗具有保护作用,对免疫功能低下者使用安全,并且不排除在人类和动物中使用结核菌素皮肤试验。