Focus10TH ANNIVERSARY SERIES

Exacting Edward Jenner’s revenge: The quest for a new tuberculosis vaccine

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Science Translational Medicine  01 May 2019:
Vol. 11, Issue 490, eaax4219
DOI: 10.1126/scitranslmed.aax4219

Figures

  • Fig. 1 Breaking the cycle of TB transmission.

    M. tuberculosis, the pathogen causing TB, is transmitted by inhalation of aerosolized microdroplets that are released by the coughing of infected individuals, usually those with cavitary lung lesions that have advanced into the bronchi. Infants and young children exposed to such infectious aerosols are highly susceptible to infection and have a high risk of developing severe, progressive disease with dissemination beyond the lungs to other organs. Cumulative deaths from TB currently total about 1.5 million globally per year. The blue boxes indicate key points in the infectious cycle where vaccination could have the greatest impact. Neonatal BCG vaccination is already well established in most countries with a high prevalence of TB. Improvements to this vaccine will likely involve introduction of modified BCG strains with better safety and immunogenicity profiles. Vaccination of uninfected or latently infected adults or older children may involve a more diverse array of new vaccine candidates such as subunit or live attenuated vaccines. Recent reports suggest benefit from revaccinating adults with BCG, and one trial has shown efficacy of the M72 subunit vaccine in prevention of disease in adults with latent TB infection.

    CREDIT: A. KITTERMAN/SCIENCE TRANSLATIONAL MEDICINE

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