特异性抗原融合蛋白结核病疫苗研究进展

结核病是一种严重危害人类健康的重大传染病,由于BCG预防效果不佳,研制新型结核病疫苗迫在眉睫。研究开发新型结核病疫苗应根据机体抗结核杆菌感染的免疫应答特点、结合BCG的不足来开展。新型结核病疫苗主要分为三类:重组BCG或重组结核菌;重组痘病毒或重组腺病毒载体疫苗;蛋白抗原亚单位或重组融合蛋白抗原亚单位疫苗。由于蛋白亚单位疫苗可以不受机体已被分枝杆菌刺激的影响,能特异性地诱导CD4+Th1细胞和CD8+细胞毒性T细胞活化,并且使用安全性好,而备受研究者的青睐。目前主要是以BCG或重组BCG初次免疫,然后选择亚单位疫苗加强免疫作为结核病疫苗序贯免疫策略。然而,单个蛋白制成亚单位疫苗,其免疫效果有限,因此将多个具有保护效果的抗原或多肽表达成融合蛋白,联合适当的佐剂,制成融合蛋白亚单位疫苗。目前,已有一些融合蛋白亚单位疫苗进入临床试验阶段,更多的融合蛋白正处于研究阶段。     

全球结核病疫苗研究进展

本文旨在对全球结核病疫苗研究进展进行系统综述,描述国际上目前进入临床试验不同阶段的新型疫苗,包括重组卡介苗、亚单位疫苗、治疗性疫苗等,分析我国结核病疫苗研究现状,介绍国际研究发展趋势,如人类疫苗计划、全细胞疫苗、多阶段疫苗等,并对存在的问题和挑战进行讨论,展望未来发展趋势。     

新型结核病疫苗及其评价方法的研究进展

结核病是由结核分枝杆菌感染引起的慢性传染病,严重危害人类健康,卡介苗对儿童粟粒性结核和结核性脑膜炎保护效果较好,但对成人肺结核保护效果却不确定。过去十余年,众多研究人员一直致力于新型结核病疫苗的研发,但至今尚未成功。结核病的致病和免疫机制还不完全清楚,缺乏可以预测临床保护效果的指标和动物模型,动物实验结果常与临床试验结果不符,临床试验耗时漫长、成本昂贵、且需要大量结核病患者,这些都严重阻碍了结核病疫苗的研发。近年来,研究人员研发了一些新方法进行结核病疫苗临床前评价,从而缩短了进入临床试验的时间,加快了结核病疫苗的发展。综述了新型结核病疫苗的研究进展及其保护力评价方法,特别是临床前评价新方法。     

《科学-转化医学》：研发出新结核病疫苗

加拿大麦克马斯特大学研究人员最近研发出一种结核病疫苗,这一成果有望取代目前唯一且已使用了50年的结核病疫苗-卡介菌苗（BCG）。研究结果在日前出版的《科学一转化医学》杂志上发表,论文显示新疫苗十分安全且对结核病有强大免疫效果。     

结核分枝杆菌蛋白亚单位疫苗与疫苗诱导的T细胞免疫记忆研究进展

牛分枝杆菌减毒活疫苗--卡介苗(bacillus Calmette-Guérin,BCG)对预防严重的儿童结核病有效,但其免疫保护效率随儿童年龄增长而降低。BCG不能提供终身免疫保护可能与其诱导的记忆性T细胞主要是寿命较短的效应记忆性T细胞有关。新型结核分枝杆菌蛋白亚单位疫苗将有效的抗原有机组合起来,在适宜的疫苗佐剂辅助下诱导Th1型免疫应答。动物实验表明,增加抗原谱可有效提高亚单位疫苗的保护效率。更重要的是,亚单位疫苗在体内持续时间较短,可诱导寿命较长的中央记忆性T细胞,提供比BCG更持久的免疫保护力。记忆性T细胞的分化受抗原特性与剂量、细胞因子、转录因子及雷帕霉素等的调控。对亚单位疫苗及其诱导的免疫记忆进行研究将对新型结核分枝杆菌疫苗的设计与评价产生积极影响。     

结核疫苗研究进展

结核病是由结核分枝杆菌感染引起的传染病,是危害人类健康的主要传染病之一。目前被广泛应用的卡介苗对于新生儿和儿童的严重播散性疾病有很好的保护效果,但对于成人活动性结核病的有效性,却存在很大的争议。近年来,人们一直努力研发新疫苗并且已经取得了一些成果。这些新型结核疫苗在临床测试中的结果是非常令人兴奋和鼓舞人心的。但是,我们仍需继续探索新型结核疫苗。     

新一代抗结核分枝杆菌疫苗将会建立在现用卡介苗的基础上吗?

本文针对以卡介苗(bacillus Calmette-Guérin,BCG)为基础的结核分枝杆菌新疫苗本身的缺陷问题、临床前药效学评价面临的问题、临床研究可能面临的有效性评价问题及伦理问题等,对"新一代抗结核分枝杆菌疫苗将会建立在现用BCG的基础上"的观点进行评述。认为以BCG为基础的新疫苗保护力可能超过现用BCG,但要显著提高其对成人的保护效果尚有难度;新疫苗用于新生儿的临床研究因存在伦理问题而可能无法开展;针对潜伏结核感染人群的免疫预防是控制结核病的重要手段,以现用BCG为基础的新疫苗可能无法应用于此类人群。因此,新一代主流抗结核分枝杆菌疫苗将不会是建立在现用BCG基础之上的疫苗。     

新型冠状病毒亚单位疫苗研究进展及现状*

自新型冠状病毒肺炎在2019年年末暴发以来,如何高效防控疫情一直是紧急的全球公共安全事件。疫苗是有效阻止病毒感染人体、保护高危人群免于疾病快速进展以及遏制疫情进一步扩大的手段之一,其中亚单位疫苗的主要成分为特定的病毒抗原蛋白或多肽,通过加入疫苗佐剂提高抗原的免疫原性。由于机体仅针对重组蛋白表面的特定抗原表位进行识别并产生抗体,因此亚单位疫苗具有较高的保护能力和安全性。通过对目前已上市及处于临床阶段的各类新型冠状病毒亚单位疫苗进行梳理,介绍了各类亚单位疫苗的抗原设计策略和佐剂选择、整体保护能力及研究进展,并对亚单位疫苗的应用及技术优势进行分析,期望能为亚单位疫苗研发及全球疫情防控提供参考。     

结核病免疫机制及疫苗研究进展

结核病是一种棘手的重大传染病.虽然存在一些有一定疗效的治疗药物,亦有预防性疫苗--卡介苗(BCG);但结核病仍在世界范围流行,且发病率和病死率居高不下.结核病的免疫病理机制及疫苗研究近年来取得了一定的进展.结核分枝杆菌通过Toll样受体(TLR)等模式识别受体,激活巨噬细胞的天然免疫反应,清除细菌和调节获得性免疫反应....     

新型结核病疫苗AEH/Al/IC在小鼠中的免疫原性研究

目的检测重组结核分枝杆菌(Mycobacterium tuberculosis,Mtb)融合蛋白Ag85B-ESAT6(Antigen 85 B,6-kDa early secretory antigenic target,AE)和热休克蛋白X(heat shock protein X,Hsp X)与氢氧化铝和聚肌胞苷酸(Polyinosinic-polycytidylic acid,poly I∶C)构建的新型结核病亚单位疫苗AEH/Al/IC在小鼠中的免疫原性。方法用疫苗(AEH/Al/IC)和佐剂(Al/Poly I∶C)分别免疫雌性BALB/c小鼠3剂次,每剂次间隔10 d。末次免疫后第10天,经ELISA检测小鼠血清中抗原特异性Ig G、Ig G1和Ig G2a的抗体效价,经酶联免疫斑点试验(enzyme-linked immunospot,ELISPOT)检测小鼠脾细胞分泌抗原特异性IFN-γ和IL-2的细胞频数,经ELISA检测小鼠脾细胞抗原特异性IFN-γ、IL-2和TNF-α的分泌量。结果与佐剂组相比,疫苗组诱导小鼠产生了高水平的AE和Hsp X特异性抗体;疫苗组诱导小鼠产生的AE和Hsp X特异性IFN-γ和IL-2阳性脾淋巴细胞(斑点形成细胞spot forming cells,SFC)均高于佐剂组,差异有统计学意义(IFN-γ:P0.05; IL-2:P0.05);疫苗组小鼠脾细胞AE特异性IFN-γ、IL-2和TNF-α分泌量明显较佐剂组高,差异均有统计学意义(P0.05),Hsp X特异性IFN-γ和TNF-α分泌量比佐剂组稍高,但差异均无统计学意义(P0.05)。结论结核病亚单位疫苗AEH/Al/IC具有良好的免疫原性,有希望成为一种新型的结核病预防候选疫苗。     

Single mucosal, but not parenteral, immunization with recombinant adenoviral-based vaccine provides potent protection from pulmonary tuberculosis

Bacillus Calmette-Guerin (BCG) vaccine has failed to control the global tuberculosis (TB) epidemic, and there is a lack of safe and effective mucosal vaccines capable of potent protection against pulmonary TB. A recombinant replication-deficient adenoviral-based vaccine expressing an immunogenic Mycobacterium tuberculosis Ag Ag85A (AdAg85A) was engineered and evaluated for its potential to be used as a respiratory mucosal TB vaccine in a murine model of pulmonary TB. A single intranasal, but not i.m., immunization with AdAg85A provided potent protection against airway Mycobacterium tuberculosis challenge at an improved level over that by cutaneous BCG vaccination. Systemic priming with an Ag85A DNA vaccine and mucosal boosting with AdAg85A conferred a further enhanced immune protection which was remarkably better than BCG vaccination. Such superior protection triggered by AdAg85 mucosal immunization was correlated with much greater retention of Ag-specific T cells, particularly CD4 T cells, in the lung and was shown to be mediated by both CD4 and CD8 T cells. Thus, adenoviral TB vaccine represents a promising novel vaccine platform capable of potent mucosal immune protection against TB. Our study also lends strong evidence that respiratory mucosal vaccination is critically advantageous over systemic routes of vaccination against TB.     

Tuberculosis vaccines: beyond bacille Calmette-Guerin

Tuberculosis (TB) disease caused by Mycobacterium tuberculosis (M. tb) remains one of the leading infectious causes of death and disease throughout the world. The only licensed vaccine, Mycobacterium bovis bacille Calmette-Guérin (BCG) confers highly variable protection against pulmonary disease. An effective vaccination regimen would be the most efficient way to control the epidemic. However, BCG does confer consistent and reliable protection against disseminated disease in childhood, and most TB vaccine strategies being developed incorporate BCG to retain this protection. Cellular immunity is necessary for protection against TB and all the new vaccines in development are focused on inducing a strong and durable cellular immune response. There are two main strategies being pursued in TB vaccine development. The first is to replace BCG with an improved whole organism mycobacterial priming vaccine, which is either a recombinant BCG or an attenuated strain of M. tb. The second is to develop a subunit boosting vaccine, which is designed to be administered after BCG vaccination, and to enhance the protective efficacy of BCG. This article reviews the leading candidate vaccines in development and considers the current challenges in the field with regard to efficacy testing.     

Protective and therapeutic efficacy of Mycobacterium smegmatis expressing HBHA-hIL12 fusion protein against Mycobacterium tuberculosis in mice

Tuberculosis (TB) remains a major worldwide health problem. The only vaccine against TB, Mycobacterium bovis Bacille Calmette-Guerin (BCG), has demonstrated relatively low efficacy and does not provide satisfactory protection against the disease. More efficient vaccines and improved therapies are urgently needed to decrease the worldwide spread and burden of TB, and use of a viable, metabolizing mycobacteria vaccine may be a promising strategy against the disease. Here, we constructed a recombinant Mycobacterium smegmatis (rMS) strain expressing a fusion protein of heparin-binding hemagglutinin (HBHA) and human interleukin 12 (hIL-12). Immune responses induced by the rMS in mice and protection against Mycobacterium tuberculosis (MTB) were investigated. Administration of this novel rMS enhanced Th1-type cellular responses (IFN-γ and IL-2) in mice and reduced bacterial burden in lungs as well as that achieved by BCG vaccination. Meanwhile, the bacteria load in M. tuberculosis infected mice treated with the rMS vaccine also was significantly reduced. In conclusion, the rMS strain expressing the HBHA and human IL-12 fusion protein enhanced immunogencity by improving the Th1-type response against TB, and the protective effect was equivalent to that of the conventional BCG vaccine in mice. Furthermore, it could decrease bacterial load and alleviate histopathological damage in lungs of M. tuberculosis infected mice.     

Adjuvants in tuberculosis vaccine development

Tuberculosis remains a major public health problem around the world. Because the Mycobacterium bovis Bacilli–Calmette–Guerin (BCG) vaccine fails to protect adults from pulmonary tuberculosis, there is an urgent need for improved vaccine formulations. Unlike BCG, recombinant vaccines purified from bacterial expression vectors, as well as naked DNA, require an additional adjuvant. Recent improvements in our understanding of disease immunopathology, together with advances in biochemical and molecular techniques, have permitted the successful development of promising tuberculosis vaccine delivery and adjuvant combinations for human use. Here, we summarize the current state of adjuvant development and its impact on tuberculosis vaccine progress.     

A New Recombinant BCG Vaccine Induces Specific Th17 and Th1 Effector Cells with Higher Protective Efficacy against Tuberculosis

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb) that is a major public health problem. The vaccine used for TB prevention is Mycobacterium bovis bacillus Calmette-Guérin (BCG), which provides variable efficacy in protecting against pulmonary TB among adults. Consequently, several groups have pursued the development of a new vaccine with a superior protective capacity to that of BCG. Here we constructed a new recombinant BCG (rBCG) vaccine expressing a fusion protein (CMX) composed of immune dominant epitopes from Ag85C, MPT51, and HspX and evaluated its immunogenicity and protection in a murine model of infection. The stability of the vaccine in vivo was maintained for up to 20 days post-vaccination. rBCG-CMX was efficiently phagocytized by peritoneal macrophages and induced nitric oxide (NO) production. Following mouse immunization, this vaccine induced a specific immune response in cells from lungs and spleen to the fusion protein and to each of the component recombinant proteins by themselves. Vaccinated mice presented higher amounts of Th1, Th17, and polyfunctional specific T cells. rBCG-CMX vaccination reduced the extension of lung lesions caused by challenge with Mtb as well as the lung bacterial load. In addition, when this vaccine was used in a prime-boost strategy together with rCMX, the lung bacterial load was lower than the result observed by BCG vaccination. This study describes the creation of a new promising vaccine for TB that we hope will be used in further studies to address its safety before proceeding to clinical trials.     

The secreted lipoprotein, MPT83, of Mycobacterium tuberculosis is recognized during human tuberculosis and stimulates protective immunity in mice

The long-term control of tuberculosis (TB) will require the development of more effective anti-TB vaccines, as the only licensed vaccine, Mycobacterium bovis bacille Calmette-Guérin (BCG), has limited protective efficacy against infectious pulmonary TB. Subunit vaccines have an improved safety profile over live, attenuated vaccines, such as BCG, and may be used in immuno-compromised individuals. MPT83 (Rv2873) is a secreted mycobacterial lipoprotein expressed on the surface of Mycobacterium tuberculosis. In this study, we examined whether recombinant MPT83 is recognized during human and murine M. tuberculosis infection. We assessed the immunogenicity and protective efficacy of MPT83 as a protein vaccine, with monophosphyl lipid A (MPLA) in dimethyl-dioctadecyl ammonium bromide (DDA) as adjuvant, or as a DNA vaccine in C57BL/6 mice and mapped the T cell epitopes with peptide scanning. We demonstrated that rMPT83 was recognised by strong proliferative and Interferon (IFN)-γ-secreting T cell responses in peripheral blood mononuclear cells (PBMC) from patients with active TB, but not from healthy, tuberculin skin test-negative control subjects. MPT83 also stimulated strong IFN-γ T cell responses during experimental murine M. tuberculosis infection. Immunization with either rMPT83 in MPLA/DDA or DNA-MPT83 stimulated antigen-specific T cell responses, and we identified MPT83(127-135) (PTNAAFDKL) as the dominant H-2(b)-restricted CD8(+) T cell epitope within MPT83. Further, immunization of C57BL/6 mice with rMPT83/MPLA/DDA or DNA-MPT83 stimulated significant levels of protection in the lungs and spleens against aerosol challenge with M. tuberculosis. Interestingly, immunization with rMPT83 in MPLA/DDA primed for stronger IFN-γ T cell responses to the whole protein following challenge, while DNA-MPT83 primed for stronger CD8(+) T cell responses to MPT83(127-135). Therefore MPT83 is a protective T cell antigen commonly recognized during human M. tuberculosis infection and should be considered for inclusion in future TB subunit vaccines.     

Protection against tuberculosis in Eurasian wild boar vaccinated with heat-inactivated Mycobacterium bovis

Tuberculosis (TB) caused by Mycobacterium bovis and closely related members of the Mycobacterium tuberculosis complex continues to affect humans and animals worldwide and its control requires vaccination of wildlife reservoir species such as Eurasian wild boar (Sus scrofa). Vaccination efforts for TB control in wildlife have been based primarily on oral live BCG formulations. However, this is the first report of the use of oral inactivated vaccines for controlling TB in wildlife. In this study, four groups of 5 wild boar each were vaccinated with inactivated M. bovis by the oral and intramuscular routes, vaccinated with oral BCG or left unvaccinated as controls. All groups were later challenged with a field strain of M. bovis. The results of the IFN-gamma response, serum antibody levels, M. bovis culture, TB lesion scores, and the expression of C3 and MUT genes were compared between these four groups. The results suggested that vaccination with heat-inactivated M. bovis or BCG protect wild boar from TB. These results also encouraged testing combinations of BCG and inactivated M. bovis to vaccinate wild boar against TB. Vaccine formulations using heat-inactivated M. bovis for TB control in wildlife would have the advantage of being environmentally safe and more stable under field conditions when compared to live BCG vaccines. The antibody response and MUT expression levels can help differentiating between vaccinated and infected wild boar and as correlates of protective response in vaccinated animals. These results suggest that vaccine studies in free-living wild boar are now possible to reveal the full potential of protecting against TB using oral M. bovis inactivated and BCG vaccines.     

Preclinical development of an in vivo BCG challenge model for testing candidate TB vaccine efficacy

There is an urgent need for an immunological correlate of protection against tuberculosis (TB) with which to evaluate candidate TB vaccines in clinical trials. Development of a human challenge model of Mycobacterium tuberculosis (M.tb) could facilitate the detection of such correlate(s). Here we propose a novel in vivo Bacille Calmette-Guérin (BCG) challenge model using BCG immunization as a surrogate for M.tb infection. Culture and quantitative PCR methods have been developed to quantify BCG in the skin, using the mouse ear as a surrogate for human skin. Candidate TB vaccines have been evaluated for their ability to protect against a BCG skin challenge, using this model, and the results indicate that protection against a BCG skin challenge is predictive of BCG vaccine efficacy against aerosol M.tb challenge. Translation of these findings to a human BCG challenge model could enable more rapid assessment and down selection of candidate TB vaccines and ultimately the identification of an immune correlate of protection.     

结核分枝杆菌免疫优势抗原研究进展

结核病是当今影响人类健康、流行性最广、病死率最高的感染性疾病之一。结核病的诊断和疫苗的构建成为当前的研究热点,筛选出结核分枝杆菌免疫优势抗原是快速准确的诊断结核病及研制安全有效的疫苗的关键。拟对近年来国内外学者发现的结核分枝杆菌免疫优势抗原的分子生物学特性研究进展进行综述。