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Construction and characterization of novel Mycobacterium tuberculosis-derived triple and quadruple knockout vaccines against tuberculosis.

Tuberculosis (TB) is a deadly disease that claims the lives of over a million people each year worldwide. The Bacille Calmette-Guérin vaccine has long been used to protect against TB, but it produces variable effects across different populations and fails to protect against adult pulmonary TB. Therefore, there is an urgent need for alternative vaccines that can offer better protection. We have developed a strategy for the rational deletion of virulence-related genes in Mycobacterium tuberculosis (Mtb) to create hyperattenuation that also enhances immunogenicity. Previously, we generated both single (∆fbpA) and double knockout (DKO) (∆fbpA-∆sapM) mutants of Mtb and assessed their immunogenicity and efficacy using mice. Herein, we have created triple knockout (TKO) and quadruple knockout (QKO) strains to enhance the immunogenicity and safety of the DKO strain by deleting the zmp1 and dosR genes. The resulting TKO strains, TKO-Z (∆fbpA-∆sapM-∆zmp1) and TKO-D (∆fbpA-∆sapM-∆dosR), and the QKO strain (∆fbpA-∆sapM-∆zmp1-∆dosR), were evaluated for their immunogenicity and safety in mice. Whereas TKO-Z and QKO strains exhibited superior immunogenicity compared to the DKO strain, their protective efficacy in mice was comparable. However, survival studies involving SCID mice indicated that the QKO strain was highly attenuated. Therefore, rational deletion of genes in Mtb seems to be an innovative approach for developing safer and more efficacious vaccines against TB.

Animals

Global biological sample collections from tuberculosis studies: a scoping review.

Progress in tuberculosis vaccine development is hindered by the incomplete understanding of protective immunity and other disease mechanisms. An interconnected network of sample biorepositories from tuberculosis studies could help to address these gaps. To assess the feasibility of such a resource, we conducted a scoping review of tuberculosis observational studies and vaccine clinical trials. The included studies collected at least one biological sample from tuberculosis cases, contacts, or controls and had more than 100 participants. We contacted the corresponding authors of these studies to determine the sample availability and interest in interconnected biorepositories. For the period 2014-24, we identified 104 observational studies and 18 vaccine trials that collected biological samples from 35 075 tuberculosis cases, 39 450 contacts or controls, and 45 628 trial participants across 43 countries. The commonly collected samples were blood, human genomic DNA, RNA, and sputum. Interest among the contacted investigators was high. Interconnected sample biorepositories could facilitate large-scale investigations and accelerate progress towards tuberculosis vaccine development.

Humans

Transfer of delayed hypersensitivity in mice to microbial antigens with dialyzable transfer factor.

Dialyzable Lawrence-type transfer factor was prepared from the spleen cells of CF1 mice inoculated with Coccidioides immitis- and Candida albicans-killed vaccines and with live Mycobacterium tuberculosis vaccine (BCG). These preparations were shown to transfer antigen-specific cell-mediated immunity to naive mice, as measured by the delayed skin test and footpad-swelling methods. Reactivity could be demonstrated when the test antigens were given 24 h after the transfer factor, but not when they were given simultaneously. Coccidioides-specific transfer factor was shown to be sensitive to Pronase and resistant to trypsin and ribonuclease. A preparation of BCG transfer factor was sensitive to snake venom phosphodiesterase.

Animals

[The influence of BCG-vaccination on the tuberculosis in children (Hamburg 1950-1971) (author's transl)].

Between 1950 to 1971 6 758 cases of active tuberculosis were registered among children under 15 years of age in Hamburg. 33 of them died, mostly due to tuberculous meningitis. In spite of a general decrease in tuberculosis during that period a relative increase of cases of pleurisy, nodular tuberculosis and tuberculous infiltrations of the lung were seen. On the other hand, cases of tuberculous meningitis and miliary tuberculosis as well as cases of glandular tuberculosis decreased. Rarely BCG-vaccinated children suffered from miliary tuberculosis, tuberculous meningitis and pleurisy. A statistical comparison between BCG-vaccinated and unvaccinated children of the birth cohorts 1954 and 1963 revealed that unvaccinated children suffered significantly more often from tuberculosis than the vaccinated. The duration of the protection by BCG-vaccination has been calculated for 7 years. BCG-vaccination after school age of the tuberculin negative persons is still debatable.

Adolescent

Assembly of the Mycobacterium tuberculosis type VII ESX-1 secretion system in Mycobacterium smegmatis identifies a new transcriptional activator of esx-1 genes and a novel TB vaccine.

Mycobacterium tuberculosis (M. tb) uses its type VII secretion system (T7SS) ESX-1 to export immunogenic, virulence-mediating protein effectors. In this study, the fast-growing, non-pathogenic model mycobacteria Mycobacterium smegmatis mc2-155 was engineered to express the M. tb T7SS ESX-1 system. We found that M. smegmatis transformed with M. tb esx-1 locus genes only, as well as M. smegmatis transformed with M. tb esx-1 and espACD operon genes (designated MSX-1), produces and secretes the M. tb ESX-1 protein effectors EsxA, EsxB, and EspB. However, the abundance of these proteins was higher inside the cell and culture filtrate of the MSX-1 strain. Although ESX-1 is critical for M. tb pathogenesis, expression of M. tb ESX-1 did not make the recombinant M. smegmatis strains virulent in macrophages. Serendipitously, transformation of M. smegmatis with a modified esx-1 locus in this study revealed rv3860, a gene of previously unknown function, to be required for the transcription of pe35, ppe68, esxB, and esxA genes. Finally, mice vaccinated with MSX-1 were found to be as protected as mice vaccinated with Mycobacterium bovis BCG against M. tb infection, without becoming sensitized to tuberculin. These results show that a functional M. tb ESX-1 system can be assembled in M. smegmatis to uncover novel facets of the secretion machinery and that the modified M. smegmatis strain can function as a tuberculosis (TB) vaccine. Unlike BCG, however, its deployment may be compatible with tests currently used to diagnose TB.IMPORTANCEIn this study, we modified Mycobacterium smegmatis, which is often used as a surrogate model organism in mycobacterial research, to produce and assemble a functional Mycobacterium tuberculosis (M. tb) ESX-1 protein secretion system. One such M. smegmatis strain named MSX-1 was found to make a functional M. tb ESX-1 system without becoming virulent. And in using M. smegmatis as a chassis to study the ESX-1 system, we found that rv3860, an M. tb gene of previously unknown function, is needed for the production of key ESX-1 proteins. Finally, mice vaccinated with MSX-1 were as protected from tuberculosis (TB) as mice given BCG, the only approved TB vaccine. Notably, we found that unlike BCG, MSX-1 does not sensitize mice to the antigens used in existing TB diagnostic tests. These observations, taken together, highlight the utility of M. smegmatis as a chassis to study the M. tb ESX-1 secretion machinery.

Mycobacterium smegmatis

[Reducing the risk of tuberculosis in children vaccinated with BCG].

In 1973, of 1774192 children aged 18 months to 6 years, 82,2% had to be revaccinated with BCG, 10.7% presented tuberculin reactions larger than 10 mm and 7.1% were absentees. In 1974 a number of 485 children belonging to the respective age group contracted tuberculosis. Analysis of these cases showed that the risk of tuberculosis was of 10.9 per 100,000 revaccinated subjects and of 74.6 per 10,000 absentees. BCG vaccination not only lowered the risk of the disease but also reduced the risk of a severe evolution and death.

BCG Vaccine

Host-parasite relationships in experimental airborne tuberculosis. VI. Influence of vaccination with Bacille Calmette-Guérin on the onset and/or extent of hematogenous dissemination of virulent Mycobacterium tuberculosis to the lungs.

Guinea pigs vaccinated with bacille Calmette-Guérin (BCG) and unvaccinated guinea pigs were challenged by the respiratory route six weeks or six months after vaccination and sacrificed at various intervals after challenge. The six lobes of the lung were cultured separately, and the percentage of culture-positive lobes was calculated, as well as the log10 number of virulent bacilli recovered. The latter was subjected to an analysis of variance, which compared the fate of bacilli in the four largest lobes with the fate of those in the two smallest lobes. The results indicated no difference between the six-week and six-month intervals between vaccination and challenge. In the longer intervals between challenge and sacrifice, small numbers of secondary lesions could be seen on the lobes of the BCG-vaccinated animals. It was concluded that vaccination with BCG retarded the onset and/or reduced the extent of hematogenous dissemination of virulent mycobacteria to the lungs.

Animals

Enhanced resistance against encephalomyocarditis virus infection in mice, induced by a nonviable Mycobacterium tuberculosis oil-droplet vaccine.

Female C57B1/10 mice injected intravenously (i.v.) with nonviable Mycobacterium tuberculosis Jamaica cells associated with oil-droplet emulsions (WCV) were highly resistant to the i.v. injection of encephalomyocarditis virus (EMCV). Resistance to infection (87% survival) was detected from 1 week to at least 12 weeks after injection of WCV. Mice vaccinated i.v. also were resistant to intraperitoneal, subcutaneous, or intramuscular virus challenge, but were not resistant to intracranial challenge. Mice vaccinated intraperitoneally also were resistant to virus infection, whereas WCV administered intramuscularly or subcutaneously did not protect mice from virus injected by any route. Less than 50% of WCV mice that survived virus challenge possessed serum anti-EMCV-neutralizing antibody (less than 1:10), and none had detectable (less than 1:10) serum interferon. Interferon was not detected in sera of WCV mice from 4 to 144 h after i.v. injection of EMCV. Studies concerning the effects of WCV on EMCV infection suggest that mice may be protected by mechanisms that inhibit early viral replication and spread of virus to the central nervous system.

Animals

Trial of BCG vaccines in south India for tuberculosis prevention: first report--Tuberculosis Prevention Trial.

The protective effect of BCG vaccination is being evaluated in a controlled community trial near Madras in south India. After tuberculin and sensitin testing and radiographic and bacteriological examinations, BCG vaccines and placebo were allocated randomly to about 260 000 individuals, of whom 115 000 were definitely tuberculin negative at the time of vaccination. Intensive efforts are being made, by means of regular follow-up surveys, to identify all new cases of tuberculosis occurring in the community. This report presents the findings of the first 7(1/2) years of follow-up. Incidence of infection was high in the study population. However, incidence of bacillary disease was more frequent among initial tuberculin reactors, especially among the older persons, than among non-reactors of whom the majority were in the younger age groups. The distribution of new cases of bacillary tuberculosis among those not infected at intake did not show any evidence of a protective effect of the BCG vaccines.

Adolescent

BCG and vole bacillus vaccines in the prevention of tuberculosis in adolescence and early adult life.

The Medical Research Council's trial of BCG and vole bacillus vaccines in the prevention of tuberculosis in Great Britain has ended after 20 years' follow-up of the 54 239 participants, who were aged 14 to 15 years when the entered the trial in 1950-2. Participants who were tuberculin positive on entry were left unvaccinated; those who were tuberculin negative were allocated at random to an unvaccinated or to a vaccinated group. The protective efficacy of each of the two vaccines, among those initially tuberculin negative, was 84% during the first five years, and gradually decreased, averaging 77% for each vaccine over the whole period. The incidence of tuberculosis decreased substantially in all groups during the trial, however, and of the total of 610 cases of tuberculosis only 27 developed between 15 and 20 years. Thus we cannot make a reliable assessment of efficacy during this final period. The prevalence and incidence of tuberculosis in Great Britain have decreased radically since this trial began. The expected benefit from large-scale BCG-vaccination of children is now far less, and may decrease further if the incidence of tuberculosis continues to decline.

Adolescent