Despite the advent of the bacille Calmette Guérin (BCG) vaccine to prevent tuberculosis infection nearly 75 years ago, the vaccine has not managed to reduce disease prevalence, especially in the developing world. In a Review in this week's edition of The Lancet, Professor Daniel Hoft, Saint Louis University Health Sciences Centre, St. Louis, MO, USA, says: "Important contributing factors might include background immunity induced by non-tuberculosis environmental mycobacteria, diversity of BCG strains, and overattenuation of presently used strains."
A third of the world's population is infected with Myobacterium tuberculosis, and two million people die from tuberculosis every year. Professor Hoft, who is director of the division of immunobiology at Saint Louis University School of Medicine, says: "In order to reduce the immense burden of tuberculosis, new vaccines or vaccination strategies, or both, are urgently needed." The Review provides details of the immune responses thought to be important for tuberculosis immunity; various mycobacterial antigens that seem to be promising targets for vaccine-induced immunity; different vaccination approaches being developed for use in people; and the key issues involved in the selection of new vaccines for expanded phase II or III testing.
Professor Hoft concludes: "Now more than ever, basic and clinical scientists should work together to ensure progress in the development of improved tuberculosis vaccines. With an improved knowledge of M tuberculosis pathogenesis and the detailed immune responses that protect against infection and disease, we hope to be successful in developing vaccines with improved effectiveness against this important disease that has so far remained a scourge of the human race."
For Professor Daniel Hoft, Saint Louis University Health Sciences Centre, St Louis, MO, USA please contact Nancy Solomon T) +1 314-977-8017 E) solomonn@slu.edu / hoftdf@slu.edu
http://multimedia.thelancet.com/pdf/press/tuberculosis.pdf
The Lancet