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New Approaches to TB VaccinationNew Approaches to TB Vaccination

Zhou Xing, MD, PhD; Mangalakumari Jeyanathan, PhD; Fiona Smaill, MD
Author and Funding Information

From McMaster Immunology Research Centre and Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.

CORRESPONDENCE TO: Zhou Xing, MD, PhD, Room 4012-MDCL, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1, Canada; e-mail: xingz@mcmaster.ca


FUNDING/SUPPORT: The studies from the authors’ laboratory were supported by funds from the Canadian Institutes of Health Research, the Natural Sciences and Engineering Research Council of Canada, and the Canadian Foundation for Innovation.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(3):804-812. doi:10.1378/chest.14-0439
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Pulmonary TB remains a leading global health issue, but the current Bacille Calmette-Guérin (BCG) vaccine fails to control it effectively. Much effort has gone into developing safe and effective boost vaccine candidates for use after the BCG prime vaccination. To date, almost all the lead candidates are being evaluated clinically via a parenteral route. Abundant experimental evidence suggests that parenteral boosting with a virus-based vaccine is much less effective than respiratory mucosal boosting, because the former fails to activate a type of T cell capable of rapidly transmigrating into the airway luminal space in the early phase of the Mycobacterium tuberculosis infection. The next few years will determine whether parenteral boosting with some of the lead vaccine candidates, particularly the protein-based vaccines, improves protection in humans over that by BCG. Much effort is needed to develop respiratory mucosal boost vaccines and to identify the reliable immune protective correlates in humans.

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