Abstract
Editorial Commentary: Understanding BCG Is the Key to Improving It
Highlights
The need for improved tuberculosis control remains a global health priority
Incremental rise in antimycobacterial immunity after BCG vaccination was much lower in these African adolescents, suggesting that the nontuberculous mycobacteria (NTM) induced immunity “masks” the effect of BCG vaccination, and that this preexisting immunity cannot be boosted with BCG
Preexposure to NTM can inhibit the protective effect of BCG, but interestingly, preexposure to NTM did not affect the efficacy of a subunit vaccine, a finding that is encouraging for the development of subunit booster vaccines [5]
Summary
The need for improved tuberculosis control remains a global health priority. The most cost-effective long-term solution for any infectious disease epidemic is effective vaccination. These include differences in BCG and M. tuberculosis strains, host genetics, nutrition, coinfection with helminths, and exposure to nontuberculous mycobacteria (NTM). Whereas the relative importance of these different mechanisms may differ by geographical area, and more than one explanation may be involved, there is increasing evidence for a role of exposure to nontuberculous mycobacteria in explaining at least some of the variability.
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