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结核病疫苗的当前趋势

Current trends in tuberculosis vaccine.

作者信息

Soundarya J S V, Ranganathan Uma Devi, Tripathy Srikanth P

机构信息

PhD Research Scholar, Department of Immunology, National Institute for Research in Tuberculosis, Chennai 600031, India.

Scientist 'D', Department of Immunology, National Institute for Research in Tuberculosis, Chennai 600031, India.

出版信息

Med J Armed Forces India. 2019 Jan;75(1):18-24. doi: 10.1016/j.mjafi.2018.12.013. Epub 2019 Jan 18.

Abstract

Despite the global efforts made to control tuberculosis (TB) and the large number of available new anti-TB drugs, TB still affects one-third of the world population. The conventional vaccine bacille Calmette-Guérin (BCG) shows varying efficacy in different populations, and there are safety issues in immunocompromised patients. Hence, there is an urgent requirement for a new and better TB vaccine candidate than BCG. There are several alternate vaccines available for TB such as DNA, subunit, adjuvant, and live-attenuated vaccines. Use of auxotrophic vaccine is an emerging technology. Newer vaccine technologies include vaccine delivery methods such as adenovirus- and cytomegalovirus (CMV)-based vector delivery, chimeric monoclonal antibody, single-chain fragment variable, RNA-lipoplexes, and nanoparticle-based technology. Based on its application, TB vaccines are classified as conventional, prophylactic, booster, therapeutic, and reinfection preventive vaccines. Currently, there are 12 vaccine candidates in clinical trials. In this review, we have briefly discussed about each of these vaccines in different phases of clinical trials. These vaccines should be analyzed further for developing a safe and more efficacious vaccine for TB.

摘要

尽管全球为控制结核病(TB)做出了努力,并且有大量可用的新型抗结核药物,但结核病仍影响着世界三分之一的人口。传统疫苗卡介苗(BCG)在不同人群中显示出不同的疗效,并且在免疫功能低下的患者中存在安全问题。因此,迫切需要一种比卡介苗更新且更好的结核病疫苗候选物。有几种用于结核病的替代疫苗,如DNA疫苗、亚单位疫苗、佐剂疫苗和减毒活疫苗。营养缺陷型疫苗的使用是一项新兴技术。更新的疫苗技术包括疫苗递送方法,如基于腺病毒和巨细胞病毒(CMV)的载体递送、嵌合单克隆抗体、单链可变片段、RNA-脂质复合物和基于纳米颗粒的技术。根据其应用,结核病疫苗分为传统疫苗、预防性疫苗、加强疫苗、治疗性疫苗和再感染预防性疫苗。目前,有12种疫苗候选物正在进行临床试验。在本综述中,我们简要讨论了这些处于不同临床试验阶段的疫苗中的每一种。这些疫苗应进一步分析,以开发出一种安全且更有效的结核病疫苗。

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本文引用的文献

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Phase 2b Controlled Trial of M72/AS01 Vaccine to Prevent Tuberculosis.M72/AS01 疫苗预防结核病的 2b 期对照试验。
N Engl J Med. 2018 Oct 25;379(17):1621-1634. doi: 10.1056/NEJMoa1803484. Epub 2018 Sep 25.

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