Do successful tuberculosis vaccines need to be immunoregulatory rather than merely Th1-boosting?

Vaccine. 2005 Mar 18;23(17-18):2115-20. doi: 10.1016/j.vaccine.2005.01.069.


Tuberculosis vaccine candidates are entering clinical studies in areas where BCG fails. This is a high-risk strategy. We suggest that geographical variation in the efficacy of BCG is related to the presence in developing countries of a cross-reactive background Th2-like response, probably attributable to exposure of mother and infant to helminths and environmental mycobacteria. Such Th2-like activity can stop Mycobacterium tuberculosis from being pushed into a latent state by the Th1 response, impair bactericidal functions and cause toxicity of TNF-alpha and pulmonary fibrosis. A successful vaccine, rather than driving a Th1 response, might need to suppress this pre-existing subversive Th2-like component.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • BCG Vaccine / immunology
  • BCG Vaccine / pharmacology
  • Developing Countries
  • Humans
  • Interleukin-4 / antagonists & inhibitors
  • Interleukin-4 / genetics
  • Interleukin-4 / metabolism
  • Mice
  • Models, Immunological
  • Mycobacterium tuberculosis / immunology
  • Mycobacterium tuberculosis / pathogenicity
  • Th1 Cells / immunology*
  • Th2 Cells / immunology
  • Treatment Failure
  • Tuberculosis Vaccines / immunology
  • Tuberculosis Vaccines / pharmacology*
  • Tuberculosis, Pulmonary / immunology
  • Tuberculosis, Pulmonary / mortality
  • Tuberculosis, Pulmonary / prevention & control


  • BCG Vaccine
  • Tuberculosis Vaccines
  • Interleukin-4