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。     

结核灭活疫苗的临床研究进展

分枝杆菌灭活疫苗(inactivated mycobacterium vaccines)是一种最原始、简单制备方法的产物,但在结核疫苗史上始终拥有一席之地。从早期的旧结核菌素和死卡介苗以及中期唯一的分枝杆菌疫苗,到如今逐个出现的新疫苗,分枝杆菌灭活疫苗仍受到研究者的重视,其用途也从结核病患者的免疫治疗,扩大到潜伏感染人群的预防和卡介苗(Bacillus Calmette-Guérin, BCG)初免后的加强免疫。现就分枝杆菌灭活疫苗的临床研究历史和现状作一综述,为新疫苗的研制提供参考。     

抗结核分枝杆菌疫苗的研究进展

结核病是由结核分枝杆菌感染引起的传染病,细胞免疫中的CD_4^+T细胞、CD_8^+T细胞、Th17细胞在对抗结核分枝杆菌感染中发挥重要作用,新近研究显示抗体特定的糖链修饰有助于清除病原体,提示体液免疫也可能参与免疫保护。目前使用的疫苗——卡介苗对婴幼儿重症结核病具有良好的保护力,但是对成人肺结核保护力欠佳,所以需要研发新的疫苗。目前已有数个新型疫苗进入临床试验。本文就结核分枝杆菌的免疫保护机制作一简要介绍,主要阐述现用疫苗——卡介苗及新型疫苗的研究现状,让读者对上述知识的进展有所了解。     

结核病疫苗研究进展

随着对抗结核免疫机制的深入研究,新型结核疫苗的研发也更加理性和成熟。近期研究表明,CD4 T细胞多功能至关重要,人类CD8和γδT细胞也有抗结核免疫保护作用,是新型疫苗设计有潜力的T细胞靶点。系统的"组学"技术大规模筛选有可能发现更多强免疫原性的抗原。不同表达时期的多抗原组成的多价疫苗对不同感染时期的结核都有预防作用。针对潜伏感染或已经感染个体配合化学药物使用的新型治疗性疫苗,有望促进清除残留的结核分枝杆菌。     

针对结核分枝杆菌潜伏感染的DNA疫苗V569免疫原性及保护性的初步研究

为研究针对结核分枝杆菌潜伏感染的DNA疫苗,基于质粒A39构建了p-VAX1-Ag85B-Rv3425-Rv2029c-PPE26 (V569)质粒DNA,并对其免疫原性及保护性进行初步研究。免疫性评价试验共分6组：PBS、p-VAX1-Ag85B(A)、p-VAX1-Ag85B-Rv3425(A3)、A39、V569和BCG,采用左后腿肌内注射C57BL/6小鼠,用流式细胞术和酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)分别检测细胞免疫和体液免疫水平;构建斑马鱼-海分枝杆菌潜伏感染模型,将PBS、A、A3、A39、BCG、V569分别通过腹腔注射免疫斑马鱼后,每日注射地塞米松10ug诱导海分枝杆菌复发感染,对斑马鱼肝脏进行菌落计数并绘制生存曲线。结果显示,与BCG组相比,V569能引发实验小鼠强烈的细胞免疫反应(IFN-γ高水平分泌),外周血CD4^＋/CD8^＋ T细胞比例明显增加。在斑马鱼-海分枝杆菌潜伏感染复发模型中,与BCG 免疫组相比,V569免疫斑马鱼后可显著减少其肝脏中海分枝杆菌数量,斑马鱼存活情况得到显著改善,表明V569 DNA疫苗可能是一种抗结核潜伏感染的候选DNA疫苗。     

结核分枝杆菌海藻糖磷酸磷酸酶诱导小鼠体液和细胞免疫应答

目的 研究结核分枝杆菌(M．tuberculosis)海藻糖磷酸磷酸酶(TPP)诱导小鼠体液和细胞免疫。方法 差速离心分离结核分枝杆菌H37Rv和卡介苗(BCG)的各细胞组分,通过Western杂交检测抗原TPP在结核分枝杆菌H37Rv和BCG中的亚细胞定位情况。分别用5×10~6CFU的BCG和50μg的TPP蛋白免疫C57BL/6小鼠,检测小鼠血清中抗TPP的IgG1和IgG2a抗体效价。取免疫小鼠的脾细胞,体外抗原刺激,用酶联免疫斑点试验(ELISPOT)检测γ干扰素(IFN-γ)分泌细胞。结果 TPP亚细胞定位于结核分枝杆菌H37Rv和BCG的胞壁和细胞膜组分。TPP蛋白免疫后小鼠产生的TPP特异性IgG1和IgG2a抗体效价明显高于BCG免疫小鼠,并且IgG2a的抗体效价高于IgG1。体外抗原刺激TPP蛋白和BCG免疫小鼠的脾细胞,都能诱导较高的IFN-γ分泌。结论 结核分枝杆菌细胞壁蛋白TPP能诱导小鼠Ⅰ型辅助性T细胞介导的免疫反应,可作为抗结核疫苗的候选抗原。     

结核分枝杆菌分泌蛋白TB10.4的功能和应用

近年来,结核的发病率又呈上升趋势,传统的结核疫苗已无法起到有效的保护作用。结核分枝杆菌分泌蛋白由于具有良好的免疫保护性因而备受关注。结核分泌蛋白TB10.4是免疫主导的蛋白,能够激发有效的免疫反应,因而成为研究结核新疫苗靶抗原之一。本文就近几年结核分枝杆菌TB10.4的相关研究作一综述。     

黏膜免疫与结核疫苗研发CSCD

结核病是全球重要的传染性疾病之一,在全球范围内保持着较高的发病率和死亡率。卡介苗是目前临床上唯一应用的结核疫苗,虽然对儿童有较好的保护作用,但对成人的免疫保护效果并不明显。研发新的结核疫苗对于结核病的防控具有重要的意义。由于结核病的致病菌结核分枝杆菌主要通过呼吸道传播,机体的黏膜成为抵御结核分枝杆菌的第一道防线。设计稳定高效的抗结核黏膜免疫疫苗是目前结核疫苗研究的新方向之一。选择合适的黏膜免疫途径、佐剂及抗原递送系统是黏膜疫苗研发成功的关键。本文对抗结核分枝杆菌的黏膜免疫应答作简短的概述,并重点阐明黏膜免疫在结核疫苗研发中的研究进展。     

黏膜免疫与结核疫苗研发

结核病是全球重要的传染性疾病之一,在全球范围内保持着较高的发病率和死亡率。卡介苗是目前临床上唯一应用的结核疫苗,虽然对儿童有较好的保护作用,但对成人的免疫保护效果并不明显。研发新的结核疫苗对于结核病的防控具有重要的意义。由于结核病的致病菌结核分枝杆菌主要通过呼吸道传播,机体的黏膜成为抵御结核分枝杆菌的第一道防线。设计稳定高效的抗结核黏膜免疫疫苗是目前结核疫苗研究的新方向之一。选择合适的黏膜免疫途径、佐剂及抗原递送系统是黏膜疫苗研发成功的关键。本文对抗结核分枝杆菌的黏膜免疫应答作简短的概述,并重点阐明黏膜免疫在结核疫苗研发中的研究进展。     

治疗性结核病疫苗研究进展

治疗性结核病疫苗主要用于接种已感染结核分枝杆菌的个体,包括化学药物治疗的患者和潜伏感染者。治疗性疫苗可逆转发生在疾病进展期的非保护性免疫反应,使其向Th1型反应发展;能打破机体的免疫耐受,有效激发宿主针对结核分枝杆菌的以抗原为基础的细胞免疫反应,诱发抗原特异性的细胞毒性T淋巴细胞免疫反应,来清除胞内寄生的结核分枝杆菌。治疗性疫苗将有助于防止潜伏结核病的复发;与药物联合使用以提高药物的治疗效果,尤其是针对耐药结核病的治疗。     

候选结核疫苗的评价模型

卡介苗作为目前唯一批准使用的预防结核疫苗,由于无法提供充足的保护力,目前结核病依然是严重危害人类健康的传染病,因此筛选优质候选疫苗迫在眉睫。所有候选疫苗进入临床试验前必须评价其安全性、免疫原性以及有效性。评价结果在一定程度上也预示候选疫苗在人体的免疫作用,也是目前评价候选疫苗是否优于传统卡介苗的依据。论述候选结核疫苗临床试验前所使用的体内和体外评价模型。对评价模型的充分认识将提高候选疫苗评价数据对人体临床试验的预测意义,也可更具体地执行实验动物的替代、减少和优化原则。     

Improving vaccines against tuberculosis

Tuberculosis remains a major cause of mortality and physical and economic deprivation worldwide. There have been significant recent advances in our understanding of the Mycobacterium tuberculosis genome, mycobacterial genetics and the host determinants of protective immunity. Nevertheless, the challenge is to harness this information to develop a more effective vaccine than BCG, the attenuated strain of Mycobacterium bovis derived by Calmette and Guérin nearly 90 years ago. Some of the limitations of BCG include the waning of the protective immunity with time, reduced effectiveness against pulmonary tuberculosis compared to disseminated disease, and the problems of a live vaccine in immuno-compromised subjects. Two broad approaches to vaccine development are being pursued. New live vaccines include either attenuated strains of Mycobacterium tuberculosis produced by random mutagenesis or targeted deletion of putative virulence factors, or by genetic manipulation of BCG to express new antigens or cytokines. The second approach utilizes non-viable subunit vaccines to deliver immunodominant mycobacterial antigens. Both protein and DNA vaccines induce partial protection against experimental tuberculosis infection in mice, however, their efficacy has generally been equivalent to or less than that of BCG. The comparative effects of cytokine adjuvants and vaccines targeting antigen presenting cells on enhancing protection will be discussed. Coimmunization with plasmid interleukin-12 and a DNA vaccine expressing Antigen 85B, a major secreted protein, was as protective as BCG. The combination of priming with DNA-85B and boosting with BCG was superior to BCG alone. Therefore it is possible to achieve a greater level of protection against tuberculosis than with BCG, and this highlights the potential for new tuberculosis vaccines in humans.     

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....     

Influence of BCG vaccine strain on the immune response and protection against tuberculosis

The Bacille Calmette–Guérin (BCG) vaccine has been used for more than 80 years to protect against tuberculosis. Worldwide, over 90% of children are immunized with BCG, making it the most commonly administered vaccine, with more than 120 million doses used each year. Although new tuberculosis vaccines are under investigation, BCG will remain the cornerstone of the strategy to fight the worsening tuberculosis pandemic for the foreseeable future. The recent delineation of genetic differences between BCG vaccine strains has renewed interest in the influence of the vaccine strain on the protective efficacy against tuberculosis. This review critically examines the data from animal and human studies comparing BCG vaccine strains. Although there is good evidence to support the notion that the induced immune response and protection afforded against tuberculosis differs between BCG vaccine strains, currently, there are insufficient data to favour or recommend one particular strain. Identifying BCG strains with superior protection would have a dramatic effect on tuberculosis control at a population level: a small increment in protection provided by BCG immunization will prevent large numbers of cases of severe tuberculosis and deaths, particularly in children.     

Correlates of immune protection from tuberculosis

Due to the failure of chemotherapy and the only available vaccine, BCG, to control tuberculosis (TB) disease, there is an urgent need to develop new vaccines and therapeutics. The identification of correlates of immune protection or "biomarkers" will facilitate the rational design of vaccines and drugs for the prevention and clearance of TB infection. Although it is known that IFN-gamma is essential for protective immunity, animal and human studies have found that IFN-gamma alone is not sufficient for the prevention of TB disease. There is evidence that IL-23, a recently described member of the IL-12 family of cytokines, is important in the immuno-pathogenesis of TB. There is also evidence that regulatory T cells (Treg) are present in TB disease and that Treg may suppress effector T cell responses. In the last five years, clinical studies have been able to use Mycobacterium tuberculosis specific antigens, such as ESAT-6, to focus on recently infected, healthy contacts of TB patients in endemic countries. Advances in techniques such as multi-parameter flow cytometry and DNA microarray analysis will enable us to study these cohorts in great detail and facilitate the identification of immune correlates for the rational design of drugs and vaccines for the treatment and prevention of TB.     

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。     

New tuberculosis vaccines based on attenuated strains of the Mycobacterium tuberculosis complex

The world urgently needs a better tuberculosis vaccine. Bacille Calmette-Guerin (BCG), an attenuated strain of Mycobacterium bovis, has been very widely used as a vaccine for many years but has had no major effect on reducing the incidence of tuberculosis. A number of alternative living and non-living vaccines are being investigated. Live vaccine candidates include genetically modified forms of BCG, genetically attenuated strains of the Mycobacterium tuberculosis complex and genetically engineered vaccinia virus and Salmonella strains. Non-living vaccine candidates include killed mycobacterial species, protein subunits and DNA vaccines. One requirement for acceptance of any new vaccine will be a favourable comparison of the protection it induces relative to BCG in a range of animal models, some of which may need further development. Molecular genetic techniques are now available that enable production of live attenuated strains of the M. tuberculosis complex with vaccine potential. In the first of two broadly different approaches that are being used, large numbers of mutants are produced by transposon mutagenesis or illegitimate recombination and are screened for properties that correlate with attenuation. In the second approach, putative genes that may be required for virulence are identified and subsequently inactivated by allelic exchange. In both approaches, mutants that are attenuated need to be identified and subsequently tested for their vaccine efficacy in animal models. Many mutants of the M. tuberculosis complex have now been produced and the vaccine properties of a substantial number will be assessed in the next 3 years.     

HspX protein as a candidate vaccine against <Emphasis Type="Italic">Mycobacterium tuberculosis</Emphasis>: an overview

Background

Tuberculosis (TB) is a contagious infectious disease caused by Mycobacterium tuberculosis (Mtb). This disease with two million deaths per year has the highest mortality rate among bacterial infections. The only available vaccine against TB is BCG vaccine. BCG is an effective vaccine against TB in childhood, however, due to some limitations, has not proper efficiency in adults. Also, BCG cannot produce an adequately protective response against reactivation of latent infections.

Objective

In the present study we will review the most recent findings about contribution of HspX protein in the vaccines against tuberculosis.

Methods

Therefore, many attempts have been made to improve BCG or to find its replacement. Most of the subunit vaccines for TB in various phases of clinical trials were constructed as prophylactic vaccines using Mtb proteins expressed in the replicating stage. These vaccines might prevent active TB but not reactivation of latent tuberculosis infection (LTBI). A literature search was performed on various online databases (PubMed, Scopus, and Google Scholar) regarding the roles of HspX protein in tuberculosis vaccines.

Results

Ideal subunit post-exposure vaccines should target all forms of TB infection, including active symptomatic and dormant (latent) asymptomatic forms. Among these subunit vaccines, HspX is the most important latent phase antigen of M. tuberculosis with a strong immunological response. There are many studies that have evaluated the immunogenicity of this protein to improve TB vaccine.

Conclusion

According to the studies, HspX protein is a good candidate for development of subunit vaccines against TB infection.

     

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.