BCG Vaccination Strategies Against Tuberculosis: Updates and Perspectives

Overview

Journal Hum Vaccin Immunother

Specialty Allergy & Immunology

Date 2021 Dec 3

PMID 34856853

Citations 17

Authors

Mengjin Qu

Xiangmei Zhou

Hao Li

Affiliations

Soon will be listed here.

Abstract

Bacillus Calmette-Guérin (BCG) is the only licensed vaccine against tuberculosis (TB). However, BCG has variable efficacy and cannot completely prevent TB infection and transmission. Therefore, the worldwide prevalence of TB calls for urgent development of a more effective TB vaccine. In the absence of other approved vaccines, it is also necessary to improve the efficacy of BCG itself. Intravenous (IV) BCG administration and BCG revaccination strategies have recently shown promising results for clinical usage. Therefore, it is necessary for us to revisit the BCG vaccination strategies and summarize the current research updates related to BCG vaccination. This literature review provides an updated overview and perspectives of the immunization strategies against TB using BCG, which may inspire the following research on TB vaccine development.

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References

Lu L, Chung A, Rosebrock T, Ghebremichael M, Yu W, Grace P . A Functional Role for Antibodies in Tuberculosis. Cell. 2016; 167(2):433-443.e14. PMC: 5526202. DOI: 10.1016/j.cell.2016.08.072. View

Agger E . Novel adjuvant formulations for delivery of anti-tuberculosis vaccine candidates. Adv Drug Deliv Rev. 2015; 102:73-82. PMC: 4870161. DOI: 10.1016/j.addr.2015.11.012. View

Bhattacharya D, Dwivedi V, Kumar S, Reddy M, Van Kaer L, Moodley P . Simultaneous inhibition of T helper 2 and T regulatory cell differentiation by small molecules enhances Bacillus Calmette-Guerin vaccine efficacy against tuberculosis. J Biol Chem. 2014; 289(48):33404-11. PMC: 4246096. DOI: 10.1074/jbc.M114.600452. View

Tameris M, Hatherill M, Landry B, Scriba T, Snowden M, Lockhart S . Safety and efficacy of MVA85A, a new tuberculosis vaccine, in infants previously vaccinated with BCG: a randomised, placebo-controlled phase 2b trial. Lancet. 2013; 381(9871):1021-8. PMC: 5424647. DOI: 10.1016/S0140-6736(13)60177-4. View

Barclay W, Anacker R, Brehmer W, Leif W, Ribi E . Aerosol-Induced Tuberculosis in Subhuman Primates and the Course of the Disease After Intravenous BCG Vaccination. Infect Immun. 1970; 2(5):574-82. PMC: 416053. DOI: 10.1128/iai.2.5.574-582.1970. View

Hesseling A, Cotton M, von Reyn C, Graham S, Gie R, Hussey G . Consensus statement on the revised World Health Organization recommendations for BCG vaccination in HIV-infected infants. Int J Tuberc Lung Dis. 2008; 12(12):1376-9. View

Suliman S, Geldenhuys H, Johnson J, Hughes J, Smit E, Murphy M . Bacillus Calmette-Guérin (BCG) Revaccination of Adults with Latent Mycobacterium tuberculosis Infection Induces Long-Lived BCG-Reactive NK Cell Responses. J Immunol. 2016; 197(4):1100-1110. PMC: 4976036. DOI: 10.4049/jimmunol.1501996. View

Rodo M, Rozot V, Nemes E, Dintwe O, Hatherill M, Little F . A comparison of antigen-specific T cell responses induced by six novel tuberculosis vaccine candidates. PLoS Pathog. 2019; 15(3):e1007643. PMC: 6417742. DOI: 10.1371/journal.ppat.1007643. View

Benevolo-de-Andrade T, Monteiro-Maia R, Cosgrove C, Castello-Branco L . BCG Moreau Rio de Janeiro: an oral vaccine against tuberculosis--review. Mem Inst Oswaldo Cruz. 2005; 100(5):459-65. DOI: 10.1590/s0074-02762005000500002. View

10.

Watanabe Y, Watari E, Matsunaga I, Hiromatsu K, Dascher C, Kawashima T . BCG vaccine elicits both T-cell mediated and humoral immune responses directed against mycobacterial lipid components. Vaccine. 2006; 24(29-30):5700-7. DOI: 10.1016/j.vaccine.2006.04.049. View

11.

Houben R, Dodd P . The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling. PLoS Med. 2016; 13(10):e1002152. PMC: 5079585. DOI: 10.1371/journal.pmed.1002152. View

12.

Seder R, Chang L, Enama M, Zephir K, Sarwar U, Gordon I . Protection against malaria by intravenous immunization with a nonreplicating sporozoite vaccine. Science. 2013; 341(6152):1359-65. DOI: 10.1126/science.1241800. View

13.

Lindenstrom T, Knudsen N, Agger E, Andersen P . Control of chronic mycobacterium tuberculosis infection by CD4 KLRG1- IL-2-secreting central memory cells. J Immunol. 2013; 190(12):6311-9. DOI: 10.4049/jimmunol.1300248. View

14.

Gopal R, Monin L, Slight S, Uche U, Blanchard E, Junecko B . Unexpected role for IL-17 in protective immunity against hypervirulent Mycobacterium tuberculosis HN878 infection. PLoS Pathog. 2014; 10(5):e1004099. PMC: 4022785. DOI: 10.1371/journal.ppat.1004099. View

15.

Sable S, Posey J, Scriba T . Tuberculosis Vaccine Development: Progress in Clinical Evaluation. Clin Microbiol Rev. 2019; 33(1). PMC: 6822991. DOI: 10.1128/CMR.00100-19. View

16.

Kowalewicz-Kulbat M, Locht C . BCG and protection against inflammatory and auto-immune diseases. Expert Rev Vaccines. 2017; 16(7):1-10. DOI: 10.1080/14760584.2017.1333906. View

17.

Li C, Chen Y, Zhao Y, Lung D, Ye Z, Song W . Intravenous Injection of Coronavirus Disease 2019 (COVID-19) mRNA Vaccine Can Induce Acute Myopericarditis in Mouse Model. Clin Infect Dis. 2021; 74(11):1933-1950. PMC: 8436386. DOI: 10.1093/cid/ciab707. View

18.

Rodrigues L, Pereira S, Cunha S, Genser B, Ichihara M, de Brito S . Effect of BCG revaccination on incidence of tuberculosis in school-aged children in Brazil: the BCG-REVAC cluster-randomised trial. Lancet. 2005; 366(9493):1290-5. DOI: 10.1016/S0140-6736(05)67145-0. View

19.

Curtis N, Sparrow A, Ghebreyesus T, Netea M . Considering BCG vaccination to reduce the impact of COVID-19. Lancet. 2020; 395(10236):1545-1546. PMC: 7252177. DOI: 10.1016/S0140-6736(20)31025-4. View

20.

Noval Rivas M, Ebinger J, Wu M, Sun N, Braun J, Sobhani K . BCG vaccination history associates with decreased SARS-CoV-2 seroprevalence across a diverse cohort of health care workers. J Clin Invest. 2020; 131(2). PMC: 7810479. DOI: 10.1172/JCI145157. View