Muhi Stephen, Stinear Timothy P
Victorian Infectious Diseases Service at the Royal Melbourne Hospital, Melbourne, Australia; Department of Microbiology and Immunology, Peter Doherty Institute at the University of Melbourne, Melbourne, Australia.
Department of Microbiology and Immunology, Peter Doherty Institute at the University of Melbourne, Melbourne, Australia.
Vaccine. 2021 Dec 8;39(50):7238-7252. doi: 10.1016/j.vaccine.2021.05.092. Epub 2021 Jun 10.
Buruli ulcer, caused by Mycobacterium ulcerans, is a neglected tropical disease endemic to over 30 countries, with increasing incidence in temperate, coastal Victoria, Australia. Strategies to control transmission are urgently required. This study systematically reviews the literature to identify and describe candidate prophylactic Buruli ulcer vaccines. This review highlights that Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccine is the only vaccine studied in randomised controlled trials and confirms its importance as a benchmark for comparison against putative vaccines in pre-clinical studies. Nevertheless, BCG alone is unable to offer long-term protection in humans. A number of experimental vaccines that exceed the protection provided by BCG in mice have emerged, particularly those utilising recombinant BCG expressing immunogenic M. ulcerans proteins. Although progress is promising, there remain key questions about the optimal approach to characterising the immunological correlates of protection in humans and strategies to investigate the safety and efficacy of such vaccines in humans.
溃疡分枝杆菌引起的布鲁里溃疡是一种被忽视的热带疾病，在30多个国家流行，在澳大利亚维多利亚州沿海的温带地区发病率不断上升。迫切需要控制传播的策略。本研究系统回顾了文献，以识别和描述候选预防性布鲁里溃疡疫苗。该综述强调，卡介苗（BCG）是唯一在随机对照试验中研究过的疫苗，并确认了其作为临床前研究中与推定疫苗进行比较的基准的重要性。然而，单独使用卡介苗无法为人类提供长期保护。已经出现了一些在小鼠中提供超过卡介苗保护效果的实验性疫苗，特别是那些利用表达免疫原性溃疡分枝杆菌蛋白的重组卡介苗的疫苗。尽管进展令人鼓舞，但在确定人类保护的免疫相关因素的最佳方法以及研究此类疫苗在人类中的安全性和有效性的策略方面，仍然存在关键问题。
