Jenner Institute, Nuffield Department of Medicine, Oxford University, ORCRB, Roosevelt Drive, Oxford OX3 7DQ, UK.
Trends Pharmacol Sci. 2011 Oct;32(10):601-6. doi: 10.1016/j.tips.2011.06.003. Epub 2011 Jul 29.
An effective tuberculosis (TB) vaccine could have a significant impact on the current TB pandemic. The past decade has seen sustained global investment into reaching this goal; currently there are several promising vaccines in clinical trials. Current strategies include the development of an improved bacille Calmette-Guerin (BCG) vaccine to be given at birth and a booster vaccine to be administered after BCG. Here, we describe the current vaccination strategy and review the main issues in novel TB vaccine development. Potential vaccine candidates are evaluated in pre-clinical animal models, and the most promising go into clinical testing; a vaccine candidate is evaluated in at least one model before progressing to early clinical trials. The main challenge in early trials is the lack of a defined correlate of vaccine-induced immune protection. Following this, large efficacy trials are undertaken, which face the daunting challenges of cost, logistics and trial site capacity.
一种有效的结核病 (TB) 疫苗可能会对当前的结核病大流行产生重大影响。过去十年，全球一直在持续投资以实现这一目标；目前有几种有前途的疫苗正在临床试验中。目前的策略包括开发一种改良的卡介苗 (BCG) 疫苗，在婴儿出生时接种，并在接种 BCG 后接种加强疫苗。在这里，我们描述了当前的疫苗接种策略，并回顾了新型结核病疫苗开发中的主要问题。潜在的疫苗候选物在临床前动物模型中进行评估，最有前途的候选物进入临床测试；在进入早期临床试验之前，候选物至少要在一种模型中进行评估。早期试验的主要挑战是缺乏疫苗诱导免疫保护的明确相关物。在此之后，进行了大规模的疗效试验，但面临着成本、后勤和试验现场能力的艰巨挑战。
