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

• Published in: Medical microbiology and immunology Vol. 202; no. 2; pp. 95 - 104
• Main Authors: Prabowo, Satria A., Gröschel, Matthias I., Schmidt, Ed D. L., Skrahina, Alena, Mihaescu, Traian, Hastürk, Serap, Mitrofanov, Rotislav, Pimkina, Edita, Visontai, Ildikó, de Jong, Bouke, Stanford, John L., Cardona, Père-Joan, Kaufmann, Stefan H. E., van der Werf, Tjip S.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.04.2013; Springer Nature B.V
• Subjects: Antitubercular Agents - therapeutic use; Biomedical and Life Sciences; Biomedicine; Drug resistance; Extensively Drug-Resistant Tuberculosis - prevention & control; Extensively Drug-Resistant Tuberculosis - therapy; Humans; Immunology; Immunotherapy; Medical Microbiology; Mycobacterium tuberculosis; Mycobacterium tuberculosis - immunology; Review; Risk Factors; Tuberculosis; Tuberculosis Vaccines - immunology; Tuberculosis Vaccines - therapeutic use; Tuberculosis, Multidrug-Resistant - prevention & control; Tuberculosis, Multidrug-Resistant - therapy; Vaccines; Virology; Tuberculosis; Immunology; Drug-resistant; Therapeutic vaccine; Immunotherapy; Persistent bacteria; Review
• ISSN: 0300-8584; 1432-1831
• DOI: 10.1007/s00430-012-0278-6

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.