South African Tuberculosis Vaccine Initiative (SATVI), Institute of Infectious Disease and Molecular Medicine, and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
South African Tuberculosis Vaccine Initiative (SATVI), Institute of Infectious Disease and Molecular Medicine, and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Vaccine. 2023 Nov 22;41(48):7060-7066. doi: 10.1016/j.vaccine.2023.10.026. Epub 2023 Oct 21.
Tuberculosis (TB) is a global health emergency. Across the globe, approximately 2 billion people are currently infected with Mycobacterium tuberculosis (Mtb), and of those, 5-10% may progress to become ill and potentially transmit the bacterium. In 2021, nearly 10.6 million people developed TB disease and 1.6 million died. There is an urgent need for accelerated development of new TB-focused interventions, in particular, improved TB vaccines. However, progress in developing highly effective TB vaccines has been slow and is chronically under-resourced. The mRNA vaccine platform may offer an opportunity to accelerate development of new TB vaccines. In April 2023, the World Health Organization convened global experts to discuss the feasibility and potential value of mRNA-based vaccines for TB. Here we report on meeting deliberations related to the current TB vaccine pipeline and potential novel antigens, the status of efforts to identify correlates of protection, potential clinical development strategies and considerations for community acceptance of new TB vaccines based on this relatively new platform. The role of industry collaborations, ethics, social science, and responsibility to the global community regarding transparency and manufacturing capacity building were discussed through expert presentations and panel sessions. The overall conclusion of the meeting is that mRNA-based vaccines constitute a potentially powerful new tool for reducing the global burden of TB.
结核病(TB)是全球卫生紧急情况。在全球范围内,目前约有 20 亿人感染结核分枝杆菌(Mtb),其中 5-10%可能会发病并有可能传播细菌。2021 年,近 1060 万人患上结核病,160 万人死亡。迫切需要加速开发新的结核病干预措施,特别是改进的结核病疫苗。然而,开发高度有效的结核病疫苗的进展缓慢,且长期资源不足。mRNA 疫苗平台可能为加速开发新的结核病疫苗提供机会。2023 年 4 月,世界卫生组织召集全球专家讨论基于 mRNA 的结核病疫苗的可行性和潜在价值。在这里,我们报告与当前结核病疫苗管道和潜在新型抗原相关的会议审议情况,确定保护相关性的努力现状,潜在的临床开发策略,以及基于这一相对较新平台的对新结核病疫苗的社区接受程度的考虑因素。通过专家演讲和小组讨论,讨论了行业合作、道德、社会科学以及对全球社区的透明度和制造能力建设的责任问题。会议的总体结论是,基于 mRNA 的疫苗是减少全球结核病负担的一种潜在强大的新工具。