Dockrell Hazel M
Pathog Dis. 2016 Jun;74(4):ftw016. doi: 10.1093/femspd/ftw016.
New and effective tuberculosis (TB) vaccines are urgently needed to control pulmonary TB, and in particular to prevent the spread of drug-resistant strains of Mycobacterium tuberculosis. These drug-resistant strains can range from those resistant to first-line drugs to those that are almost impossible to treat. To develop new and effective vaccines for HIV and malaria has been difficult and it is proving to be just as challenging for TB. TB is a complicated disease with a spectrum from apparently controlled latent infection to active clinical disease and so different types of preventive or post-exposure vaccine may be needed. Identifying the most promising vaccine candidates to move into clinical trials is difficult, as we lack biomarker signatures that can predict protective efficacy. There is a risk that the failure of the MVA-85A vaccine to show efficacy when given to previously BCG-vaccinated South African infants will impact on the resources available for the development and trials of other candidate TB vaccines. Continued support for the development of new TB vaccines should remain a priority as an effective vaccine would bring huge public health benefits.
迫切需要新型有效的结核病（TB）疫苗来控制肺结核，特别是预防耐药结核分枝杆菌菌株的传播。这些耐药菌株范围广泛，从对一线药物耐药的菌株到几乎无法治疗的菌株。开发针对艾滋病毒和疟疾的新型有效疫苗一直很困难，事实证明开发结核病疫苗同样具有挑战性。结核病是一种复杂的疾病，从明显受控的潜伏感染到活动性临床疾病，因此可能需要不同类型的预防性或暴露后疫苗。由于缺乏能够预测保护效力的生物标志物特征，确定最有希望进入临床试验的候选疫苗很困难。给先前接种过卡介苗的南非婴儿接种MVA - 85A疫苗未能显示出疗效，这可能会影响用于其他候选结核病疫苗开发和试验的资源。持续支持新型结核病疫苗的开发应仍然是一项优先事项，因为有效的疫苗将带来巨大的公共卫生益处。
