Friday 23 March 2012

TUBERCULOSIS: A new global strategy for TB vaccines

Michael Regnier
Saturday 24 March, it will be exactly 130 years since Robert Koch identified the cause of tuberculosis (TB) and while there is a vaccine used widely around the world (Bacille Calmette-Guérin, or BCG), it has not proved effective enough to stop this disease killing one and a half million people every year.
Earlier this week, a new Strategic Blueprint for TB vaccines was published in the journal Tuberculosis. Its purpose is to once again draw attention to the need for new TB vaccines to complement or replace BCG, which was first used in humans in 1921. The drive for new tools to prevent, diagnose and treat TB is particularly important in the context of rising reports of drug-resistant TB around the world.
BCG works very well at protecting newborn children against severe forms of TB early in their lives but it is not sufficiently effective against pulmonary TB, which affects adolescents and adults and is now the most common form of the disease. The Blueprint’s authors call for researchers, clinicians, advocates, vaccine manufacturers and governments around the world to work together on creative approaches to vaccine development.
The Blueprint was edited by Dr Jelle Thole, director of the Tuberculosis Vaccine Initiatve (TBVI) and Dr Michael Brennan, senior adviser for scientific and global affairs at Aeras, a non-profit working to develop new TB vaccines. They acknowledge progress in the last decade, which has seen 15 TB vaccine candidates enter clinical trials. The most advanced of those candidates is MVA85A, which has been developed by Dr Helen McShane, a Wellcome Trust Senior Clinical Research Fellow, with funding from Aeras, the Wellcome Trust and other agencies. MVA85A is currently in phase IIb clinical trials, the results from which will determine its safety and effectiveness as a vaccine.
However, we cannot take it for granted that any of the 15 candidate vaccines in the pipeline will prove successful enough to stop TB. Research funded by the Wellcome Trust and many others continues into the basic biology of the mycobacteria that cause TB and possible new ways to fight the infection.

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