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Open AccessReview

Preclinical Progress of Subunit and Live Attenuated Mycobacterium tuberculosis Vaccines: A Review following the First in Human Efficacy Trial

Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
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Pharmaceutics 2020, 12(9), 848; https://doi.org/10.3390/pharmaceutics12090848
Received: 1 August 2020 / Revised: 2 September 2020 / Accepted: 3 September 2020 / Published: 6 September 2020
(This article belongs to the Special Issue Tuberculosis Vaccine Research and Development)
Tuberculosis (TB) is the global leading cause of death from an infectious agent with approximately 10 million new cases of TB and 1.45 million deaths in 2018. Bacille Calmette-Guérin (BCG) remains the only approved vaccine for Mycobacterium tuberculosis (M. tb, causative agent of TB), however clinical studies have shown BCG has variable effectiveness ranging from 0–80% in adults. With 1.7 billion people latently infected, it is becoming clear that vaccine regimens aimed at both post-exposure and pre-exposure to M. tb will be crucial to end the TB epidemic. The two main strategies to improve or replace BCG are subunit and live attenuated vaccines. However, following the failure of the MVA85A phase IIb trial in 2013, more varied and innovative approaches are being developed. These include recombinant BCG strains, genetically attenuated M. tb and naturally attenuated mycobacteria strains, novel methods of immunogenic antigen discovery including for hypervirulent M. tb strains, improved antigen recognition and delivery strategies, and broader selection of viral vectors. This article reviews preclinical vaccine work in the last 5 years with focus on those tested against M. tb challenge in relevant animal models. View Full-Text
Keywords: tuberculosis; Bacille Calmette-Guerin; BCG; recombinant Mycobacterium bovis BCG; attenuated Mycobacterium tuberculosis; subunit vaccine; viral vector vaccine; vaccines; mycobacteria; M. tb; TB; novel TB vaccine; clinical trial; preclinical tuberculosis; Bacille Calmette-Guerin; BCG; recombinant Mycobacterium bovis BCG; attenuated Mycobacterium tuberculosis; subunit vaccine; viral vector vaccine; vaccines; mycobacteria; M. tb; TB; novel TB vaccine; clinical trial; preclinical
MDPI and ACS Style

Watt, J.; Liu, J. Preclinical Progress of Subunit and Live Attenuated Mycobacterium tuberculosis Vaccines: A Review following the First in Human Efficacy Trial. Pharmaceutics 2020, 12, 848.

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