Current efforts and future prospects in the development of live mycobacteria as vaccines

摘要

The development of more effective vaccines against Mycobacterium tuberculosis (Mtb) remains amajor goal in the effort to reduce the enormous global burden of disease caused by this pathogen.Whole-cell vaccines based on live mycobacteria with attenuated virulence represent an appealingapproach, providing broad antigen exposure and intrinsic adjuvant properties to prime durableimmune responses. However, designing vaccine strains with an optimal balance betweenattenuation and immunogenicity has proven to be extremely challenging. Recent basic and clinicalresearch efforts have broadened our understanding of Mtb pathogenesis and created numerousnew vaccine candidates that have been designed to overcome different aspects of immune evasionby Mtb. In this review, we provide an overview of the current efforts to create improved vaccinesagainst tuberculosis based on modifications of live attenuated mycobacteria. In addition, we discussthe use of such vaccine strains as vectors for stimulating protective immunity against otherinfectious diseases and cancers.