Institute of Biostructures and Bioimaging, IBB, CNR, 80131 Naples, Italy.
Department of Pharmacy, University of Naples "Federico II", 80131 Naples, Italy.
Cells. 2023 Jan 14;12(2):317. doi: 10.3390/cells12020317.
Tuberculosis (TB) is still the leading global cause of death from an infectious bacterial agent. Limiting tuberculosis epidemic spread is therefore an urgent global public health priority. As stated by the WHO, to stop the spread of the disease we need a new vaccine, with better coverage than the current BCG vaccine. This vaccine was first used in 1921 and, since then, there are still no new licensed tuberculosis vaccines. However, there is extremely active research in the field, with a steep acceleration in the past decades, due to the advance of technologies and more rational vaccine design strategies. This review aims to gather latest updates in vaccine development in the various clinical phases and to underline the contribution of Structural Vaccinology (SV) to the development of safer and effective antigens. In particular, SV and the development of vaccine adjuvants is making the use of subunit vaccines, which are the safest albeit the less antigenic ones, an achievable goal. Indeed, subunit vaccines overcome safety concerns but need to be rationally re-engineered to enhance their immunostimulating effects. The larger availability of antigen structural information as well as a better understanding of the complex host immune response to TB infection is a strong premise for a further acceleration of TB vaccine development.
结核病（TB）仍然是全球因感染细菌病原体而导致死亡的主要原因。因此，限制结核病的传播是全球紧迫的公共卫生优先事项。正如世界卫生组织所述，要阻止疾病的传播，我们需要一种新的疫苗，其覆盖范围要优于目前的卡介苗疫苗。该疫苗于 1921 年首次使用，自那时以来，仍没有新的获得许可的结核病疫苗。然而，由于技术的进步和更合理的疫苗设计策略，该领域的研究极其活跃，在过去几十年中呈加速发展态势。本综述旨在收集各临床阶段疫苗开发的最新进展，并强调结构疫苗学（SV）对开发更安全有效的抗原的贡献。特别是，SV 和疫苗佐剂的开发正在使使用亚单位疫苗成为可能，亚单位疫苗是最安全的，但抗原性较弱。事实上，亚单位疫苗克服了安全性问题，但需要进行合理的重新设计，以增强其免疫刺激作用。更大程度地提供抗原结构信息以及更好地了解宿主对结核感染的复杂免疫反应，是进一步加速结核病疫苗开发的重要前提。
