产生 T 细胞记忆以预防结核病。
The generation of T-cell memory to protect against tuberculosis.
机构信息
Discipline of Infectious Diseases and Immunology, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Tuberculosis Research Program, Centenary Institute, Sydney, NSW, Australia.
出版信息
Immunol Cell Biol. 2019 Aug;97(7):656-663. doi: 10.1111/imcb.12275. Epub 2019 Jun 12.
Tuberculosis (TB) kills more individuals each year than any other single pathogen and a more effective vaccine is critical for the global control of the disease. Although there has been recent progress in the clinical testing of candidates, no new vaccine has been licensed for use and correlates of protective immunity in humans have not been defined. Prior Mycobacterium tuberculosis infection does not appear to confer long-term protective immunity in humans; thus mimicking the natural immune response to infection may not be a suitable approach to develop improved TB vaccines. Data from animal testing are used to progress vaccines through the "vaccine pipeline", but studies in animals have not been able to predict efficacy in humans. Furthermore, although the generation of conventional CD4 T-cell responses are considered necessary to control infection with M. tuberculosis, these do not necessarily correlate with protection induced by candidate vaccines and other immune components may play a role, including donor unrestricted T cells, tissue-resident memory T cells and anti-M. tuberculosis antibodies. This review will summarize the current understanding of the protective immune responses following M. tuberculosis infection or vaccination, with a particular focus on vaccines that have recently entered clinical trials.
结核病(TB)每年导致的死亡人数超过其他任何单一病原体,因此,开发更有效的疫苗对于全球控制该疾病至关重要。尽管候选疫苗的临床测试最近取得了一些进展,但尚未有新的疫苗获得许可使用,人类保护性免疫的相关性也尚未确定。先前的结核分枝杆菌感染似乎并不能在人类中提供长期的保护性免疫;因此,模拟对感染的自然免疫反应可能不是开发改良型结核病疫苗的合适方法。动物试验数据用于通过“疫苗管道”推进疫苗的发展,但动物研究未能预测疫苗在人类中的疗效。此外,尽管产生常规 CD4 T 细胞反应被认为是控制结核分枝杆菌感染所必需的,但这些反应并不一定与候选疫苗诱导的保护相关,其他免疫成分可能发挥作用,包括无供体限制的 T 细胞、组织驻留记忆 T 细胞和抗结核分枝杆菌抗体。本文将综述结核分枝杆菌感染或接种疫苗后保护性免疫应答的最新认识,特别关注最近进入临床试验的疫苗。