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。     

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。     

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。     

动态

新型结核病疫苗研制成功　德国马普学会传染病生物学研究所研制出一种新型结核病疫苗 ,能够有效增强机体免疫力并能有的放矢地消灭结核病菌。疫苗具有一种特殊的蛋白质分子 ,能够刺激产生T淋巴细胞 ,增强机体免疫系统功能 ,对吞噬细胞内的病菌进行有效攻击。疫苗的有效免疫期为 1 5 0天 ,预计将在一年后进入临床试验。日本开发出早老性痴呆治疗性疫苗　据《日本经济新闻》报道 ,早老性痴呆症 (阿尔茨海默氏症 )是贝塔淀粉样蛋白在脑细胞中沉淀 ,大脑发生萎缩引起的痴呆症。日本国立疗养所中部医院长寿医疗研究中心的原英夫等研究员利用基因…     

表达结核抗原的减毒重组李斯特菌的免疫生物学特性北大核心CSCD

【目的】结核病是一种由结核分枝杆菌复合群引起的严重危害人类健康的慢性传染病,研制预防结核病的新型疫苗对于有效控制结核病具有重要的公共卫生意义。【方法】本研究对表达M.tb融合蛋白的重组李斯特菌LMΔhly::Ag85b-esat-6的免疫生物学特性进行了初步研究。【结果】实验结果显示,重组菌溶血活性丧失,对C57BL/6小鼠的半数致死剂量提高了4个log值,以0.1 LD50的剂量尾静脉注射C57BL/6小鼠,5天时被完全清除,病理切片结果未显示明显病理变化,表明重组菌具有良好的安全性。以尾静脉途径免疫C57BL/6小鼠,对其诱导的免疫应答测定结果表明,重组菌所运送的结核抗原能诱导小鼠Th1型免疫应答,激发较强的结核抗原特异性的CTL效应。【结论】上述实验结果表明,表达结核分枝杆菌融合蛋白的减毒重组李斯特菌是一种安全的结核病疫苗候选株,具有潜在的应用价值。     

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....     

“重大传染病研究专项结核病发病机制与疫苗专题研讨会”会议简报

“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项已经启动。复旦大学和兰州大学等单位负责或参加了其中2 个课题———“结核病疫苗研究”和“结核分枝杆菌感染的免疫机制研究”。为了更好地实施该研究项目, 兰州大学结核病研究中心邀请国内、外同行于2009 年7 月16—20 日在兰州举办了“重大传染病研究专项结核病发病机制与疫苗专题研讨会”。参加会议的专家有......     

结核疫苗研究的新动向

近年来,由于人类免疫缺陷病毒的广泛传播和结核分枝杆菌耐药菌株的出现,使结核病在全球范围内的发病率大幅度上升,而其唯一的疫苗——卡介苗所具有的保护效果又颇有争议。因此,开发新型结核疫苗迫在眉睫。本文就近年来抗结核免疫机制以及3种结核疫苗研究的进展作一介绍。     

结核病的免疫生物学标志

目前对于新型结核疫苗的评价、结核病的诊断和治疗方案变更等并没有确定的免疫学评价标准。对结核菌和宿主免疫系统之间相互作用的了解无疑可以找到合适的生物指标。在2011年4月Nature Review Im-     

对研发新型结核病疫苗的分析和展望

结核病是公共卫生当前面临的重要问题。由于BCG预防效果不佳,研究和开发新型结核病疫苗显得必须且急迫。新型结核病疫苗的研究开发路径和观念也经历了变迁,当前主流的研发路径有重组BCG或重组结核菌、重组痘病毒或重组腺病毒载体疫苗、蛋白质亚单位或重组融合蛋白质亚单位疫苗三类,它们在疫苗效力前景,抗原选型、配方、剂型,免疫应答,疫苗生产,疫苗质量控制,临床前研究动物试验,临床试验和使用,对结核病公共卫生政策的影响等方面各有优劣。新型结核病疫苗的成功研发,还需要病原学、发病机制、免疫学和疫苗研发科学的进一步努力。     

兔结核病模型的应用研究进展

结核病(tuberculosis,TB)由结核分枝杆菌(Mycobacterium tuberculosis,MTB)感染所致,是严重危害患者身心健康的慢性传染病。目前TB的发病机制尚未完全阐明。因此建立恰当的动物模型有助于进一步探索TB发病机制、研发全新高效疫苗,优化治疗方案提供可靠的实验和理论依据。兔TB模型是应用较为广泛的动物模型之一。综述了兔TB模型构建特点及应用进展,从免疫机制和可行性角度深入分析兔TB模型的优势及其局限性,同时梳理了近年来国内外通过构建兔TB模型用于药物研究、疫苗研发和TB治疗方案评价等方面发挥的作用,为临床研究提供参考。     

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.     

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.     

Disease model: pulmonary tuberculosis

In spite of a massive effort to apply the tools currently available for tuberculosis (TB) control, both in this country and abroad, it is clear that complicating factors [for example, HIV co-infection, drug resistance, lack of patient compliance with chemotherapy, variable efficacy of Bacille Calmette-Guerin (BCG) vaccine] will prevent disease control unless new drugs, vaccines and diagnostic tests are developed (1). The publication of the complete genome sequence of Mycobacterium tuberculosis in 1998 (2) has facilitated a directed search for virulence genes, new drug targets, and vaccine antigens. This research effort has been made possible by the availability of highly biologically relevant animal models of pulmonary TB ((3)).     

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.

     

Vaccines against Tuberculosis: Where Are We and Where Do We Need to Go?

In this review we discuss recent progress in the development, testing, and clinical evaluation of new vaccines against tuberculosis (TB). Over the last 20 years, tremendous progress has been made in TB vaccine research and development: from a pipeline virtually empty of new TB candidate vaccines in the early 1990s, to an era in which a dozen novel TB vaccine candidates have been and are being evaluated in human clinical trials. In addition, innovative approaches are being pursued to further improve existing vaccines, as well as discover new ones. Thus, there is good reason for optimism in the field of TB vaccines that it will be possible to develop better vaccines than BCG, which is still the only vaccine available against TB.     

Liposome-based cationic adjuvant formulations (CAF): Past,present, and future

The use of liposomes as vaccine adjuvants has been investigated extensively over the last few decades. In particular, cationic liposomal adjuvants have drawn attention, with dimethyldioctadecylammonium (DDA) liposomes as a prominent candidate. However, cationic liposomes are, in general, not sufficiently immunostimulatory, which is why the combination of liposomes with immunostimulators has arisen as a strategy in the development of novel adjuvant systems in recent years. One such adjuvant system is CAF01. In this review, we summarize the immunological properties making CAF01 a promising versatile adjuvant system, which was developed to mediate protection against tuberculosis (TB) but, in addition, has shown promising protective efficacy against other infectious diseases requiring different immunological profiles. Further, we describe the stabilization properties that make CAF01 suitable in vaccine formulation for the developing world, which in addition to vaccine efficacy, are important prerequisites for any novel TB vaccine to reach global implementation. The encouraging nonclinical data led to a preclinical vaccine toxicology study of the TB model vaccine, Ag85B-ESAT-6/CAF01, that concluded that CAF01 has a satisfactory safety profile to advance the vaccine into phase I clinical trials, which are scheduled to start in 2009.     

Tuberculosis Vaccines and Prevention of Infection

SUMMARY

Tuberculosis (TB) is a leading cause of death worldwide despite the availability of effective chemotherapy for over 60 years. Although Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccination protects against active TB disease in some populations, its efficacy is suboptimal. Development of an effective TB vaccine is a top global priority that has been hampered by an incomplete understanding of protective immunity to TB. Thus far, preventing TB disease, rather than infection, has been the primary target for vaccine development. Several areas of research highlight the importance of including preinfection vaccines in the development pipeline. First, epidemiology and mathematical modeling studies indicate that a preinfection vaccine would have a high population-level impact for control of TB disease. Second, immunology studies support the rationale for targeting prevention of infection, with evidence that host responses may be more effective during acute infection than during chronic infection. Third, natural history studies indicate that resistance to TB infection occurs in a small percentage of the population. Fourth, case-control studies of BCG indicate that it may provide protection from infection. Fifth, prevention-of-infection trials would have smaller sample sizes and a shorter duration than disease prevention trials and would enable opportunities to search for correlates of immunity as well as serve as a criterion for selecting a vaccine product for testing in a larger TB disease prevention trial. Together, these points support expanding the focus of TB vaccine development efforts to include prevention of infection as a primary goal along with vaccines or other interventions that reduce the rate of transmission and reactivation.     

Rv1268c protein peptide inhibiting Mycobacterium tuberculosis H37Rv entry to target cells

Tuberculosis (TB) remains one of the most worrying infectious diseases affecting public health around the world; 8.7 million new TB cases were reported in 2011. The search for an Mycobacterium tuberculosis H37Rv protein sequence which is functionally important in host-pathogen interaction has been proposed for developing a new vaccine which will allow efficient and safe control of the spread of this disease.The present study thus reports the results obtained for the Rv1268c protein described in the M. tuberculosis H37Rv genome as a hypothetical unknown, probably secreted, protein based on a highly robust, specific, sensitive and functional approach to the search for potential epitopes to be included in an anti-tuberculosis vaccine. Rv1268c presence was determined by immunoblotting after obtaining polyclonal sera against mycobacterial total sonicate or subcellular fractions. Such sera were used in electron immunomicroscopy (EIM) for confirming protein localisation on the M. tuberculosis envelop by recognising colloidal gold-labelled immunoglobulin. Screening assays revealed the presence of two sequences having high binding activity: one binding A549 alveolar epithelial cells (¹⁴¹TGMAALEQYLGSGHAVIVSI¹⁶⁰) and other binding U937 monocyte-derived macrophages (²¹AVALGLASPADAAAGTMYGD⁴⁰). Such sequences’ ability to inhibit mycobacterial entry during in vitro assays was analysed. The structure of synthetic peptides binding to target cells was also determined, bearing in mind the structure–function relationship. These results, together with those obtained for other proteins, have been involved in selecting peptides which might be included in a subunit-based anti-tuberculosis vaccine.