Abstract
TB remains a very significant global health burden. There is an urgent need for better tools for TB control, which include an effective vaccine. Bacillus Calmette–Guérin (BCG), the currently licensed vaccine, confers highly variable protection against pulmonary TB, the main source of TB transmission. Replacing BCG completely or boosting BCG with another vaccine are the two current strategies for TB vaccine development. Delivering a vaccine by aerosol represents a way to match the route of vaccination to the route of infection. This route of immunisation offers not only the scientific advantage of delivering the vaccine directly to the respiratory mucosa, but also practical and logistical advantages. This review summarises the state of current TB vaccine candidates in the pipeline, reviews current progress in aerosol administration of vaccines in general and evaluates the potential for TB vaccine candidates to be administered by the aerosol route.
Highlights
TB vaccine strategiesThe only licensed vaccine against TB is bacille Calmette-Guerin (BCG), which was developed after 13 years of continuous in vitro passage of Mycobacterium bovis, the pathogen that causes TB in cattle.[7]
TB remains a very significant global health burden
This review summarises the state of current TB vaccine candidates in the pipeline, reviews current progress in aerosol administration of vaccines in general and evaluates the potential for TB vaccine candidates to be administered by the aerosol route
Summary
The only licensed vaccine against TB is bacille Calmette-Guerin (BCG), which was developed after 13 years of continuous in vitro passage of Mycobacterium bovis, the pathogen that causes TB in cattle.[7]. In a recent efficacy trial in BCG-vaccinated infants, vaccine induced immune responses were much weaker and no significant improvement in efficacy above BCG alone was seen.[30] AdHu5Ag85A has been shown to be effective at protecting against M.tb challenge when administered intranasally in several animal models as a stand-alone vaccine or as a boost to a BCG prime.[48,49] A phase I study of intramuscular immunisation with AdHu5Ag85A has recently been completed showing the vaccine to be safe, well tolerated and immunogenic in BCGnaıve and BCG-vaccinated healthy volunteers, with more potent immunogenicity in the latter group.[50]. Serial testing in people with increasing mycobacterial burden over the last decade has demonstrated no immunopathology with MVA85A or any other candidate TB vaccine tested to date.[53] Another concern is the use of TB vaccines in HIV-infected individuals in whom susceptibility to TB is increased. There is an increasing focus on a mucosal route of vaccination, in order to match the route of vaccination to route of natural infection
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
