Abstract
Pulmonary tuberculosis (TB) remains a global health concern with an astounding 9 million new cases and 2 million deaths per year. This leading infectious cause of death remains highly prevalent with one third of the world’s population latently infected with Mycobacterium tuberculosis (M.tb) despite routine vaccination against TB in endemic areas. The only approved TB vaccine is the Bacille Calmette-Guerin (BCG), which provides protection against childhood miliary tuberculosis and has been administered intradermally in humans for almost a century. While effective in preventing disseminated forms of TB, the BCG has variable efficacy in providing protection against pulmonary TB. Therefore, the BCG has been unable to control the instance of adult pulmonary TB which constitutes the global disease burden. Despite the fact that mechanisms underlying the lack of pulmonary protection provided by the BCG remain poorly understood, it remains the “Gold Standard” for vaccine-mediated protection against M.tb and will continue to be used for the foreseeable future. Therefore, continued effort has been placed on understanding the mechanisms behind the failure of BCG to provide sufficient protection against M.tb in the lung and to design new vaccines to be used in conjunction with the BCG as boost strategies to install protective immunity at the site of infection. Growing evidence supports that the route of immunization dictates the geographical location of TB-reactive T cells, and it is this distribution which predicts the protective outcome of such vaccine-elicited immunity. Such vaccines that are able to localize TB-reactive T cells to the lung and airway mucosa are thought to fill the “immunological gap” in the lung that is required for enhanced protection against M.tb infection. This chapter focuses on the critical importance of T cell geography when designing new immunization strategies against pulmonary TB.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
World Health Organization (2009) Global tuberculosis control. World Health Organization, Geneva
Cooper AM (2009) T cells in mycobacterial infection and disease. Curr Opin Immunol 21(4):378–384
Cooper AM (2009) Cell-mediated immune responses in tuberculosis. Annu Rev Immunol 27(1):393–422
Jeyanathan M, Heriazon A, Xing Z (2010) Airway luminal T cells: a newcomer on the stage of TB vaccination strategies. Trends Immunol 31(7):247–252
Xing Z (2009) Importance of T-cell location rekindled: Implication for tuberculosis vaccination strategies. Expert Rev Vaccines 8(11):1465–1468
Ly LH, McMurray DN (2008) Tuberculosis: vaccines in the pipeline. Expert Rev Vaccines 7(5):635–650
Xing Z, Charters TJ (2007) Heterologous boost vaccines for bacillus Calmette-Guerin prime immunization against tuberculosis. Expert Rev Vaccines 6(4):539–546
Parida SK, Kaufmann SH (2010) Novel tuberculosis vaccines on the horizon. Curr Opin Immunol 22(3):374–384
Shaler C, Horvath C, Lai R, Xing Z (2012) Understanding delayed T cell priming, lung recruitment and airway luminal T cell responses in host defense against pulmonary tuberculosis. Clin Dev Immunol 2012:628293
Horvath C, Shaler CR, Jeyanathan M, Zganiacz A, Xing Z (2012) Mechanisms of delayed anti-tuberculosis protection in the lung of parenteral-BCG vaccinated hosts: a critical role of airway luminal T cells. Mucosal Immunol 5(4):420–431
Begum D et al (2009) Accelerated induction of mycobacterial antigen-specific CD8+ T cells in the Mycobacterium tuberculosis-infected lung by subcutaneous vaccination with Mycobacterium bovis bacille Calmette–Guérin. Immunology 128(4):556–563
McShane H et al (2001) Enhanced immunogenicity of CD4(+) t-cell responses and protective efficacy of a DNA-modified vaccinia virus Ankara prime-boost vaccination regimen for murine tuberculosis. Infect Immun 69(2):681–686
Huygen K (2006) DNA vaccines against mycobacterial diseases. Future Microbiol 1(1):63–73
Doherty TM et al (2004) Comparative analysis of different vaccine constructs expressing defined antigens from Mycobacterium tuberculosis. J Infect Dis 190(12):2146–2153
Zhang X et al (2007) Intramuscular immunization with a monogenic plasmid DNA tuberculosis vaccine: enhanced immunogenicity by electroporation and co-expression of GM-CSF transgene. Vaccine 25(7):1342–1352
Wang J et al (2004) Single mucosal, but not parenteral, immunization with recombinant adenoviral-based vaccine provides potent protection from pulmonary tuberculosis. J Immunol 173(10):6357–6365
Goonetilleke NP et al (2003) Enhanced immunogenicity and protective efficacy against Mycobacterium tuberculosis of bacille Calmette-Guerin vaccine using mucosal administration and boosting with a recombinant modified vaccinia virus Ankara. J Immunol 171(3):1602–1609
Jeyanathan M et al (2008) Airway delivery of soluble mycobacterial antigens restores protective mucosal immunity by single intramuscular plasmid DNA tuberculosis vaccination: role of proinflammatory signals in the lung. J Immunol 181(8):5618–5626
Radosevic K et al (2007) Protective immune responses to a recombinant adenovirus type 35 tuberculosis vaccine in two mouse strains: CD4 and CD8 T-cell epitope mapping and role of gamma interferon. Infect Immun 75(8):4105–4115
Chen L et al (2004) Single intranasal mucosal Mycobacterium bovis BCG vaccination confers improved protection compared to subcutaneous vaccination against pulmonary tuberculosis. Infect Immun 72(1):238–246
Giri PK, Verma I, Khuller GK (2006) Protective efficacy of intranasal vaccination with Mycobacterium bovis BCG against airway Mycobacterium tuberculosis challenge in mice. J Infect 53(5):350–356
Garcia-Contreras L et al (2008) Immunization by a bacterial aerosol. Proc Nat Acad Sci U S A 105(12):4656–4660
Hubbard RD, Flory CM, Collins FM (1992) Immunization of mice with mycobacterial culture filtrate proteins. Clin Exp Immunol 87(1):94–98
Coler RN et al (2001) Vaccination with the T cell antigen Mtb 8.4 protects against challenge with Mycobacterium tuberculosis. J immunol 166(10):6227–6235
Giri PK et al (2005) Comparative evaluation of intranasal and subcutaneous route of immunization for development of mucosal vaccine against experimental tuberculosis. FEMS Immunol Med Microbiol 45(1):87–93
Xing Z, Lichty BD (2006) Use of recombinant virus-vectored tuberculosis vaccines for respiratory mucosal immunization. Tuberculosis 86(3–4):211–217
Lasaro MO, Ertl HC (2009) New insights on adenovirus as vaccine vectors. Mol Ther 17(8):1333–1339
Santosuosso M et al (2005) Mechanisms of mucosal and parenteral tuberculosis vaccinations: adenoviral-based mucosal immunization preferentially elicits sustained accumulation of immune protective CD4 and CD8 T cells within the airway lumen. J Immunol 174(12):7986–7994
Jeyanathan M et al (2010) Murine airway luminal antituberculosis memory CD8 T cells by mucosal immunization are maintained via antigen-driven in situ proliferation, independent of peripheral T cell recruitment. Am J Respir Crit Care Med 181(8):862–872
Mu J, Jeyanathan M, Shaler CR, Horvath C, Damjanovic D, Zganiacz A, Kugathasan K, McCormick S, Xing Z (2010) Respiratory mucosal immunization with adenovirus gene transfer vector induces helper CD4 T cell-independent protective immunity. J Gene Med 12:693–704
Radosevic K, Wieland CW, Rodriguez A, Weverling GJ, Mintardjo R, Gillissen G, Vogels R, Skeiky YA, Hone DM, Sadoff JC, van der Poll T, Havenga M, Goudsmit J (2007) Protective immune responses to a recombinant adenovirus type 35 tuberculosis vaccine in two mouse strains: CD4 and CD8 T-cell epitope mapping and role of gamma interferon. Infect Immun 75(8):4105–4115
Roediger EK, Kugathasan K, Zhang X, Lichty BD, Xing Z (2008) Heterologous boosting of recombinant adenoviral prime immunization with a novel vesicular stomatitis virus vectored vaccine for pulmonary tuberculosis. Mol Ther 16:1161–1169
Dietrich J, Andersen C, Rappuoli R, Doherty TM, Jensen CG, Andersen P (2006) Mucosal administration of Ag85B-ESAT-6 protects against infection with Mycobacterium tuberculosis and boosts prior bacillus Calmette-Guerin immunity. J Immunol 177(9):6353–6360
Andersen CS, Dietrich J, Agger EM, Lycke NY, Lövgren K, Andersen P (2007) The combined CTA1-DD/ISCOMs vector is an effective intranasal adjuvant for boosting prior Mycobacterium bovis BCG immunity to Mycobacterium tuberculosis. Infect Immun 75(1):408–416
Haile M et al (2005) Nasal boost with adjuvanted heat-killed BCG or arabinomannan-protein conjugate improves primary BCG-induced protection in C57BL/6 mice. Tuberculosis 85(1–2):107–114
Gilbert SC et al (2006) Synergistic DNA-MVA prime-boost vaccination regimes for malaria and tuberculosis. Vaccine 24(21):4554–4561
Santosuosso M et al (2006) Intranasal boosting with an adenovirus-vectored vaccine markedly enhances protection by parenteral Mycobacterium bovis BCG immunization against pulmonary tuberculosis. Infect Immun 74(8):4634–4643
Forbes EK et al (2008) Multifunctional, high-level cytokine-producing Th1 cells in the lung, but not spleen, correlate with protection against Mycobacterium tuberculosis aerosol challenge in mice. J Immunol 181(7):4955–4964
Ronan EO, Lee LN, Beverley PC, Tchilian EZ (2009) Immunization of mice with a recombinant adenovirus vaccine inhibits the early growth of Mycobacterium tuberculosis after infection. PLoS ONE 4(12):e8235
Xing Z, McFarland CT, Sallenave JM, Izzo A, Wang J, McMurray DN (2009) Intranasal mucosal boosting with an adenovirus-vectored vaccine markedly enhances the protection of BCG-primed uinea pigs against pulmonary tuberculosis. PLoS ONE 4(6):e5856
Tchilian EZ, Ronan EO, de Lara C, Lee LN, Franken KL, Vordermeier MH, Ottenhoff TH, Beverley PC (2011) Simultaneous immunization against tuberculosis. PLoS ONE 6(11):e27477
Santosuosso M et al (2007) Mucosal luminal manipulation of T cell geography switches on protective efficacy by otherwise ineffective parenteral genetic immunization. J Immunol 178(4):2387–2395
Wooley J (2011) Tuberculosis vaccine candidates—2011. Stop TB Partnership. Available via Tuberculosis Vaccine Initiative. http://www.tbvi.eu/fileadmin/user_upload/Documenten/News/TB_Vaccine_Pipeline_2011_FINAL03042012.pdf. Accessed August 2012
Acknowledgments
The work from authors’ laboratory is supported by funds from the Canadian Institutes for Health Research. Authors are grateful to Christopher Shaler for his assistance in graphic design.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Horvath, C.N., Xing, Z. (2013). Immunization Strategies Against Pulmonary Tuberculosis: Considerations of T Cell Geography. In: Divangahi, M. (eds) The New Paradigm of Immunity to Tuberculosis. Advances in Experimental Medicine and Biology, vol 783. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6111-1_14
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6111-1_14
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6110-4
Online ISBN: 978-1-4614-6111-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)