What we have learned and what we have missed in tuberculosis pathophysiology fos a new vaccine design: searching for the "pink swan"
Cardona, Pere-Joan (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	This is a call to encourage the search for a new vaccine to stop the progression of Mycobacterium tuberculosis infection to tuberculosis (TB) disease. TB is a highly discreet and stigmatized disease, with a massive impact on human health. It has killed 1. 2 billion people in the last 200 years and still kills 1. 5 million people per year. Over the last 20 years, the TB vaccine field has experienced spectacular developments, and we have learned about (1) the importance of the Th1 response in controlling infection, mainly against RD1 and Ag85 antigens; (2) the stability of the antigenic repertoire; (3) the dynamics of M. tuberculosis granulomas; or (4) the link between typical and atypical pulmonary TB and the immune status of the host. However, we still do not (1) know how to avoid M. tuberculosis infection and reinfection; (2) understand the major role of the increase in lesion size in progression from infection to disease; (3) the role of interlobular septa in encapsulating pulmonary lesions; or (4) the role of neutrophilic infiltration and an exaggerated inflammatory response in the development of TB disease. These are strong reasons to pursue new, imaginative proposals involving both the antibody response and a balanced, tolerant immune response that averts progression toward TB. So far, the scientific mindset has been quite monolithic and has mainly focused on the stimulation of conventional T cells. But this approach has failed. For that reason, we are seeking unconventional perspectives to find a "pink swan," a more efficacious and safer vaccine candidate.
Ajuts:	Instituto de Salud Carlos III PI14/01038 Instituto de Salud Carlos III PI11/01702
Nota:	Altres ajuts: This study was funded by the Generalitat de Catalunya through the Health Department and the CERCA Programme; the Spanish Government through the CIBER CRP-TB project; Plan Nacional I+D+I co-financed by ISCIII-Subdirección General de Evaluación and Fondo-EU de Desarrollo Regional (FEDER)
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; Article ; Versió publicada
Matèria:	Mycobacterium tuberculosis ; Bacillus Calmette-Guerin vaccine ; Pink swan ; Dynamic hypothesis ; Mycobacterium tuberculosis tolerance ; Damage theory
Publicat a:	Frontiers in Immunology 1664-3224, Vol. 8 Núm. 556 (may 2017) , p. 1-11

DOI: 10.3389/fimmu.2017.00556
PMID: 28555137

11 p, 2.1 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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