BCG - old workhorse, new skills

Curr Opin Immunol. 2017 Aug;47:8-16. doi: 10.1016/j.coi.2017.06.007. Epub 2017 Jul 15.

Abstract

Bacille Calmette-Guérin (BCG), the only tuberculosis (TB) vaccine in clinical practice, has limitations in efficacy, immunogenicity and safety. Much current TB vaccine research focuses on engineering live mycobacteria to interfere with phagosome biology and host intracellular pathways including apoptosis and autophagy, with candidates such as BCG Δzmp1, BCG ΔureC::hly, BCG::ESX-1Mmar, Mtb ΔphoP ΔfadD26, Mtb ΔRD1 ΔpanCD and M. smegmatis Δesx-3::esx-3(Mtb) in the development pipeline. Correlates of protection in preclinical studies include increased central memory CD4+ T cells and recruitment of antigen-specific T cells to the lungs, with mucosal vaccination found to be superior to parenteral vaccination. Finally, recent studies suggest beneficial non-specific effects of BCG on immunity, which should be taken into account when considering these vaccines for BCG replacement.

Publication types

  • Review

MeSH terms

  • Animals
  • Apoptosis
  • Autophagy
  • BCG Vaccine / immunology*
  • CD4-Positive T-Lymphocytes / immunology*
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Genetic Engineering
  • Humans
  • Immunologic Memory
  • Mycobacterium bovis / genetics
  • Mycobacterium bovis / immunology*
  • Mycobacterium tuberculosis / immunology*
  • Tuberculosis / immunology*
  • Tuberculosis / prevention & control
  • Vaccination
  • Vaccines, Synthetic

Substances

  • BCG Vaccine
  • Vaccines, Synthetic