The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK.
Semin Immunopathol. 2020 Jun;42(3):315-331. doi: 10.1007/s00281-020-00794-0. Epub 2020 Mar 18.
Mycobacterium tuberculosis remains the leading cause of death attributed to a single infectious organism. Bacillus Calmette-Guerin (BCG), the standard vaccine against M. tuberculosis, is thought to prevent only 5% of all vaccine-preventable deaths due to tuberculosis, thus an alternative vaccine is required. One of the principal barriers to vaccine development against M. tuberculosis is the complexity of the immune response to infection, with uncertainty as to what constitutes an immunological correlate of protection. In this paper, we seek to give an overview of the immunology of M. tuberculosis infection, and by doing so, investigate possible targets of vaccine development. This encompasses the innate, adaptive, mucosal and humoral immune systems. Though MVA85A did not improve protection compared with BCG alone in a large-scale clinical trial, the correlates of protection this has revealed, in addition to promising results from candidate such as VPM1002, M72/ASO1E and H56:IC31 point to a brighter future in the field of TB vaccine development.
结核分枝杆菌仍然是由单一感染源导致死亡的主要原因。卡介苗（BCG）是预防结核分枝杆菌的标准疫苗，但据认为，它只能预防 5%的所有可通过疫苗预防的结核病死亡，因此需要一种替代疫苗。针对结核分枝杆菌开发疫苗的主要障碍之一是感染免疫反应的复杂性，不确定什么是保护的免疫学相关因素。在本文中，我们试图概述结核分枝杆菌感染的免疫学，并通过这样做，研究疫苗开发的可能目标。这包括先天、适应性、黏膜和体液免疫系统。尽管在一项大规模临床试验中，MVA85A 并未与 BCG 单独使用相比提高保护作用，但它所揭示的保护相关因素，以及候选疫苗如 VPM1002、M72/ASO1E 和 H56:IC31 的有希望的结果，都指向了结核疫苗开发领域的更光明的未来。
