Tuberculosis (TB) is a serious infectious disease caused by infection with Mycobacterium tuberculosis, and kills more people annually than any other single infectious agent. Although a vaccine is available, it is only moderately effective and an improved vaccine is urgently needed. The ability to develop a more effective vaccine has been thwarted by a lack of understanding of the mechanism of vaccine-induced immune protection. Over recent decades, many novel TB vaccines have been developed and almost all have aimed to generate memory CD4 T cells. In this review, we critically evaluate evidence in the literature that supports the contention that memory CD4 T cells are the prime mediators of vaccine-induced protection against TB. Because of the lack of robust evidence supporting memory CD4 T cells in this role, the potential for B-cell antibody and "trained" innate cells as alternative mediators of protective immunity is explored.

中文翻译：

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超越记忆T细胞：抵抗结核感染的保护性免疫机制。

结核病（TB）是由结核分枝杆菌感染引起的一种严重的传染病，每年造成的死亡人数超过任何其他单一传染原。尽管有疫苗可用，但它仅是中等有效的，迫切需要改进的疫苗。缺乏对疫苗诱导的免疫保护机制的了解，阻碍了开发更有效疫苗的能力。在最近的几十年中，已经开发了许多新颖的结核病疫苗，并且几乎所有疫苗都旨在产生记忆性CD4 T细胞。在这篇综述中，我们对文献中的证据进行了严格的评估，这些证据支持以下观点：记忆CD4 T细胞是疫苗诱导的抗TB保护作用的主要媒介。由于缺乏有力的证据支持记忆CD4 T细胞发挥这一作用，