The Bacille Calmette-Guérin (BCG) vaccine has been used for more than 80 years to protect against tuberculosis. Worldwide, over 90% of children are immunized with BCG, making it the most commonly administered vaccine, with more than 120 million doses used each year. Although new tuberculosis vaccines are under investigation, BCG will remain the cornerstone of the strategy to fight the worsening tuberculosis pandemic for the foreseeable future. The recent delineation of genetic differences between BCG vaccine strains has renewed interest in the influence of the vaccine strain on the protective efficacy against tuberculosis. This review critically examines the data from animal and human studies comparing BCG vaccine strains. Although there is good evidence to support the notion that the induced immune response and protection afforded against tuberculosis differs between BCG vaccine strains, currently, there are insufficient data to favour or recommend one particular strain. Identifying BCG strains with superior protection would have a dramatic effect on tuberculosis control at a population level: a small increment in protection provided by BCG immunization will prevent large numbers of cases of severe tuberculosis and deaths, particularly in children.

中文翻译：

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卡介苗疫苗株对免疫应答和结核病防护的影响。

BacilleCalmette-Guérin（BCG）疫苗已经使用了80多年，可以预防结核病。在全球范围内，超过90％的儿童接受了BCG免疫，使其成为最常用的疫苗，每年使用的疫苗超过1.2亿剂。尽管正在研究新的结核病疫苗，但在可预见的将来，卡介苗仍将是抗击日益恶化的结核病大流行战略的基石。最近对BCG疫苗株之间遗传差异的描述重新引起了人们对疫苗株对结核病防护功效的影响的兴趣。这篇评论严格审查了来自动物和人类研究的数据，比较了BCG疫苗株。尽管有充分的证据支持BCG疫苗株之间针对肺结核的诱导的免疫反应和保护作用有所不同的观点，但目前，尚无足够的数据支持或推荐一种特定的菌株。在人群水平上鉴定出具有优良保护作用的BCG菌株将对控制结核病产生巨大影响：BCG免疫所提供的少量保护作用可预防大量严重结核病和死亡病例，特别是在儿童中。