Targeting multidrug-resistant tuberculosis (MDR-TB) by therapeutic vaccines.

Medical microbiology and immunology 2013 Apr

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Tuberculosis (TB) has scourged humankind for millennia, and latent infection affects nearly one-third of today's world population. The emergence of multidrug-resistant (MDR)-TB is a major global threat and reflects treatment failure of drug-sensitive disease. MDR-TB management is a burden for patients and society; success rates are unacceptably low with prolonged treatment duration. Mycobacterium tuberculosis (Mtb) possesses the ability to transform into a dormant state in which it can persist in the face of antimicrobial treatment and host defense. This sub-population of persisters is largely responsible for lengthy and difficult treatment. Targeting persistent bacilli could eventually improve the treatment success rate (currently 50-65 %) and shorten duration of treatment. A subset of therapies in the pipeline, termed therapeutic vaccines, use the host immune response to attack Mtb. The historical occurrence of an exacerbated host response has resulted in a negative perception of therapeutic vaccines. Thus, a renewed concept of immunotherapy is needed. We review current perspectives of immunotherapy in MDR-TB based on the knowledge of TB immunology and briefly discuss the profiles of several therapeutic vaccine products.

Citation

Satria A Prabowo, Matthias I Gröschel, Ed D L Schmidt, Alena Skrahina, Traian Mihaescu, Serap Hastürk, Rotislav Mitrofanov, Edita Pimkina, Ildikó Visontai, Bouke de Jong, John L Stanford, Père-Joan Cardona, Stefan H E Kaufmann, Tjip S van der Werf. Targeting multidrug-resistant tuberculosis (MDR-TB) by therapeutic vaccines. Medical microbiology and immunology. 2013 Apr;202(2):95-104