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Immune Responses to Bacillus Calmette-Guérin Vaccination: Why Do They Fail to
Protect against Mycobacterium tuberculosis?
#MMPMID28424703
Moliva JI
; Turner J
; Torrelles JB
Front Immunol
2017[]; 8
(?): 407
PMID28424703
show ga
Mycobacterium tuberculosis (M.tb), the causative agent of tuberculosis (TB), is
the current leading cause of death due to a single infectious organism. Although
curable, the broad emergence of multi-, extensive-, extreme-, and total-drug
resistant strains of M.tb has hindered eradication efforts of this pathogen.
Furthermore, computational models predict a quarter of the world's population is
infected with M.tb in a latent state, effectively serving as the largest
reservoir for any human pathogen with the ability to cause significant morbidity
and mortality. The World Health Organization has prioritized new strategies for
improved vaccination programs; however, the lack of understanding of
mycobacterial immunity has made it difficult to develop new successful vaccines.
Currently, Mycobacterium bovis bacillus Calmette-Guérin (BCG) is the only vaccine
approved for use to prevent TB. BCG is highly efficacious at preventing meningeal
and miliary TB, but is at best 60% effective against the development of pulmonary
TB in adults and wanes as we age. In this review, we provide a detailed summary
on the innate immune response of macrophages, dendritic cells, and neutrophils in
response to BCG vaccination. Additionally, we discuss adaptive immune responses
generated by BCG vaccination, emphasizing their specific contributions to
mycobacterial immunity. The success of future vaccines against TB will directly
depend on our understanding of mycobacterial immunity.
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