Department of Immunology, Max Planck Institute for Infection Biology, Berlin, Germany.
Lancet Infect Dis. 2011 Aug;11(8):633-40. doi: 10.1016/S1473-3099(11)70146-3.
Tuberculosis is one of the most deadly infectious diseases. The situation is worsening because of co-infection with HIV and increased occurrence of drug resistance. Although the BCG vaccine has been in use for 90 years, protection is insufficient; new vaccine candidates are therefore needed. 12 potential vaccines have gone into clinical trials. Ten are aimed at prevention of tuberculosis and, of these, seven are subunit vaccines either as adjuvanted or viral-vectored antigens. These vaccines would be boosters of BCG-prime vaccination. Three vaccines are recombinant BCG constructs-possible replacements for BCG. Additional vaccine candidates will enter clinical trials in the near future, including postexposure vaccines for individuals with latent infection. In the long term, vaccines that prevent or eradicate infection with Mycobacterium tuberculosis would be the best possible option. Improved knowledge of immunology, molecular microbiology, cell biology, biomics, and biotechnology has paved the way towards an effective and safe vaccine against tuberculosis. The pipeline of new vaccine candidates from preclinical to clinical testing could be accelerated by development of biomarkers that can predict the clinical outcome of tuberculosis.
结核病是最致命的传染病之一。由于与艾滋病毒的合并感染和耐药性的增加，情况正在恶化。尽管卡介苗疫苗已经使用了 90 年，但保护作用不足；因此需要新的疫苗候选物。12 种潜在的疫苗已经进入临床试验。其中 10 种旨在预防结核病，其中 7 种是作为佐剂或病毒载体抗原的亚单位疫苗。这些疫苗将作为卡介苗初免接种的加强剂。三种疫苗是重组卡介苗构建体，可能替代卡介苗。在不久的将来，将有更多的疫苗候选物进入临床试验，包括针对潜伏性感染个体的暴露后疫苗。从长远来看，预防或消除结核分枝杆菌感染的疫苗将是最好的选择。对免疫学、分子微生物学、细胞生物学、生物信息学和生物技术的深入了解，为开发针对结核病的有效和安全疫苗铺平了道路。通过开发能够预测结核病临床结果的生物标志物，可以加速从临床前到临床试验的新疫苗候选物的研发管道。
