Antibodies and tuberculosis
File(s)
Accepted version
Accepted version
Author(s)
Jacobs, A
Mongkolsapaya, J
Screaton, GR
McShane, HM
Wilkinson, RJ
Type
Journal Article
Abstract
Tuberculosis (TB) remains a major public health problem internationally, causing 9.6 million new cases and 1.5 million
deaths worldwide in 2014. The Bacillus Calmette-Guérin vaccine is the only licensed vaccine against TB, but its
protective effect does not extend to controlling the development of infectious pulmonary disease in adults. The
development of a more effective vaccine against TB is therefore a pressing need for global health. Although it is
established that cell-mediated immunity is necessary for the control of latent infection, the presupposition that such
immunity is sufficient for vaccine-induced protection has recently been challenged. A greater understanding of
protective immunity against TB is required to guide future vaccine strategies against TB. In contrast to cell-mediated
immunity, the human antibody response against M.tb is conventionally thought to exert little immune control over the
course of infection. Humoral responses are prominent during active TB disease, and have even been postulated to
contribute to immunopathology. However, there is evidence to suggest that specific antibodies may limit the
dissemination of M.tb, and potentially also play a role in prevention of infection via mucosal immunity. Further,
antibodies are now understood to confer protection against a range of intracellular pathogens by modulating immunity
via Fc-receptor mediated phagocytosis. In this review, we will explore the evidence that antibody-mediated immunity
could be reconsidered in the search for new vaccine strategies against TB.
deaths worldwide in 2014. The Bacillus Calmette-Guérin vaccine is the only licensed vaccine against TB, but its
protective effect does not extend to controlling the development of infectious pulmonary disease in adults. The
development of a more effective vaccine against TB is therefore a pressing need for global health. Although it is
established that cell-mediated immunity is necessary for the control of latent infection, the presupposition that such
immunity is sufficient for vaccine-induced protection has recently been challenged. A greater understanding of
protective immunity against TB is required to guide future vaccine strategies against TB. In contrast to cell-mediated
immunity, the human antibody response against M.tb is conventionally thought to exert little immune control over the
course of infection. Humoral responses are prominent during active TB disease, and have even been postulated to
contribute to immunopathology. However, there is evidence to suggest that specific antibodies may limit the
dissemination of M.tb, and potentially also play a role in prevention of infection via mucosal immunity. Further,
antibodies are now understood to confer protection against a range of intracellular pathogens by modulating immunity
via Fc-receptor mediated phagocytosis. In this review, we will explore the evidence that antibody-mediated immunity
could be reconsidered in the search for new vaccine strategies against TB.
Date Issued
2016-08-27
Date Acceptance
2016-08-04
Citation
Tuberculosis, 2016, 101, pp.102-113
ISSN
1873-281X
Publisher
Elsevier
Start Page
102
End Page
113
Journal / Book Title
Tuberculosis
Volume
101
Copyright Statement
© 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
(http://creativecommons.org/licenses/by/4.0/).
License URL
Sponsor
Wellcome Trust
Wellcome Trust
Wellcome Trust
Medical Research Council (MRC)
Grant Number
097816/Z/11/ZR
097816/Z/11/B
104803/Z/14/ZR
MR/N012658/1
Subjects
Microbiology
11 Medical And Health Sciences
Publication Status
Published