What Have We Learnt about BCG Vaccination in the Last 20 Years?

What Have We Learnt about BCG Vaccination in the Last 20 Years?
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DOI:
10.3389/fimmu.2017.01134
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发表时间:
2017
影响因子:
7.3
通讯作者:
Smith SG
Smith SG
中科院分区:
医学2区
文献类型:
--
作者:
Dockrell HM;Smith SG

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许多新型结核病疫苗已经或正在进入临床试验,其中包括转基因分枝杆菌、病毒载体递送的分枝杆菌抗原或佐剂中的分枝杆菌抗原。其中一些疫苗旨在取代现有的 BCG 疫苗,但其他疫苗将在出生后不久接种 BCG 疫苗后作为加强疫苗。显然,现有的卡介苗疫苗对肺结核的保护作用不完整且可变。本综述将讨论过去 20 年来我们所了解到的卡介苗疫苗如何诱导特异性和非特异性免疫、哪些因素影响卡介苗诱导的免疫反应,以及从卡介苗疫苗研究中识别结核病免疫相关性的进展。关于卡介苗疫苗还有很多东西需要了解,所获得的见解可以帮助开发更具保护性的疫苗。
A number of new tuberculosis (TB) vaccines have been or are entering clinical trials, which include genetically modified mycobacteria, mycobacterial antigens delivered by viral vectors, or mycobacterial antigens in adjuvant. Some of these vaccines aim to replace the existing BCG vaccine but others will be given as a boosting vaccine following BCG vaccination given soon after birth. It is clear that the existing BCG vaccines provide incomplete and variable protection against pulmonary TB. This review will discuss what we have learnt over the last 20 years about how the BCG vaccine induces specific and non-specific immunity, what factors influence the immune responses induced by BCG, and progress toward identifying correlates of immunity against TB from BCG vaccination studies. There is still a lot to learn about the BCG vaccine and the insights gained can help the development of more protective vaccines.
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