Comparative Immunology, Microbiology and Infectious Diseases 36(2013)287-294 Contents lists available at SciVerse Science Direct Comparative Immunology, Microbiology and infectious diseases ELSEVIER journalhomepagewww.elsevier.com/locate/cimid Review a new tb vaccine: Fact or fiction? Paul d. van helden*. Eileen g. hoal ivision of Molecular Biology and Human bosch University, P O Box 19063, Tygerberg 7505, South Africa ARTICLE INFO A B STRACT Vaccination has been spectacularly successful in eradicating or controlling some infectious diseases, and is particularly attractive as an approach to tackling other infectious diseases. Although vaccination against tuberculosis has been done for nearly 100 years, it is clearly not that successful since the disease still occurs at epidemic levels in animals and humans in many areas. New approaches to vaccination against TB in humans and animals are cur- rently in the pipeline, but none show either complete protection or sterilization. However there is evidence to suggest that vaccination may deliver some positive outcomes. Not only should we be investigating new vaccines, but also how vaccines and candidates are used and delivered. There are many reasons to think that this task will not be simple, or perhaps no possible in some cases We present different aspects of the development of vaccines against TB, outline some complications and suggest some new ways to consider this problem. O2012 Elsevier Ltd. All rights reserved. 1. Background/introduction 2. Prior or acquired immunity? 3. Animal models 4. Choice of vaccine candidates 6. Where should we target our intervention step? 7. Vaccine administration and delivery 8. Clinical trials, evaluation and end-points 8999 9. will vaccination make a significant impact? 10. Goal of vaccination ……291 11. Will a new vaccine merely shift the population structure of mycobacteria? 12. Future prospects Acknowledgments References 292 1. Background/ introduction generally not an option for animals, with the exception of mycobacteriosis, or tuberculosis(TB)is still common the occasional animal in captivity. For TB. as with other today in both humans and animals. At present, we can treat diseases, prevention is better than cure, and thus attempts the disease in humans with antibiotic treatment this is have been made to produce a vaccine against tb for over 100 years. This paper aims to briefly review the field in terms of human and animal reaction to vaccination against r.TeL:+270219389401;fax:+270219389863 TB and highlights some of the difficulties and progress in the field front matter o 2012 Elsevier Ltd. All rights reserved. 0.1016/ timid201207003Comparative Immunology, Microbiology and Infectious Diseases 36 (2013) 287–294 Contents lists available at SciVerse ScienceDirect Comparative Immunology, Microbiology and Infectious Diseases jou rn al h om epage: www.elsevier.com/locate/cimid Review A new TB vaccine: Fact or fiction? Paul D. van Helden∗, Eileen G. Hoal DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 19063, Tygerberg 7505, South Africa a r t i c l e i n f o Keywords: Tuberculosis Humans Animals Vaccination Prevention Susceptibility a b s t r a c t Vaccination has been spectacularly successful in eradicating or controlling some infectious diseases, and is particularly attractive as an approach to tackling other infectious diseases. Although vaccination against tuberculosis has been done for nearly 100 years, it is clearly not that successful since the disease still occurs at epidemic levels in animals and humans in many areas. New approaches to vaccination against TB in humans and animals are cur￾rently in the pipeline, but none show either complete protection or sterilization. However, there is evidence to suggest that vaccination may deliver some positive outcomes. Not only should we be investigating new vaccines, but also how vaccines and candidates are used and delivered. There are many reasons to think that this task will not be simple, or perhaps not possible in some cases. We present different aspects ofthe development of vaccines against TB, outline some complications and suggest some new ways to consider this problem. © 2012 Elsevier Ltd. All rights reserved. Contents 1. Background/introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287 2. Prior or acquired immunity? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 3. Animal models . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 4. Choice of vaccine candidates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 5. Possible complications? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 6. Where should we target our intervention step? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 7. Vaccine administration and delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 8. Clinical trials, evaluation and end-points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 9. Will vaccination make a significant impact? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 10. Goal of vaccination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 11. Will a new vaccine merely shift the population structure of mycobacteria? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 12. Future prospects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 1. Background/introduction Mycobacteriosis, or tuberculosis (TB) is still common today in both humans and animals. At present, we can treat the disease in humans with antibiotic treatment. This is ∗ Corresponding author. Tel.: +27 021 9389401; fax: +27 021 9389863. E-mail address: pvh@sun.ac.za (P.D. van Helden). generally not an option for animals, with the exception of the occasional animal in captivity. For TB, as with other diseases, prevention is better than cure, and thus attempts have been made to produce a vaccine against TB for over 100 years. This paper aims to briefly review the field in terms of human and animal reaction to vaccination against TB and highlights some of the difficulties and progress in the field. 0147-9571/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.cimid.2012.07.003