College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA.
Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, USA.
Hum Vaccin Immunother. 2021 Aug 3;17(8):2454-2470. doi: 10.1080/21645515.2021.1885280. Epub 2021 Mar 26.
Despite aggressive eradication efforts, Tuberculosis (TB) remains a global health burden, one that disproportionally affects poorer, less developed nations. The only vaccine approved for TB, the Bacillus of Calmette and Guérin (BCG) vaccine remains controversial because it's stated efficacy has been cited as anywhere from 0 to 80%. Nevertheless, there have been exciting discoveries about the mechanism of action of the BCG vaccine that suggests it has a role in immunization schedules today. We review recent data suggesting the vaccine imparts protection against both tuberculosis and non-tuberculosis pathogens via a newly discovered immune system called trained immunity. BCG's efficacy also appears to be tied to its affect on granulocytes at the epigenetic and hematopoietic stem cell levels, which we discuss in this article at length. We also write about how the different strains of the BCG vaccine elicit different immune responses, suggesting that certain BCG strains are more immunogenic than others. Finally, our review delves into how the current vaccine is being reformulated to be more efficacious, and track the development of the next generation vaccines against TB.
尽管采取了积极的根除措施，但结核病（TB）仍然是全球健康负担，这一问题在较贫穷、欠发达的国家更为严重。目前唯一获得批准用于结核病的疫苗是卡介苗（BCG）疫苗，但它的效果仍存在争议，因为其效果被认为在 0 到 80%之间。然而，关于卡介苗疫苗作用机制的一些令人兴奋的发现表明，它在当今的免疫接种计划中具有一定作用。我们回顾了最近的数据，这些数据表明，该疫苗通过一种新发现的免疫系统——训练有素的免疫，对结核病和非结核病病原体提供保护。卡介苗的疗效似乎也与其在表观遗传和造血干细胞水平上对粒细胞的影响有关，我们在本文中对此进行了详细讨论。我们还介绍了卡介苗疫苗的不同菌株如何引发不同的免疫反应，这表明某些卡介苗菌株比其他菌株更具免疫原性。最后，我们的综述深入探讨了如何对当前疫苗进行改良以提高其效力，并跟踪针对结核病的下一代疫苗的发展。
