Mycobacterium tuberculosis remains the leading cause of death attributed to a single infectious organism. Bacillus Calmette-Guerin (BCG), the standard vaccine against M. tuberculosis, is thought to prevent only 5% of all vaccine-preventable deaths due to tuberculosis, thus an alternative vaccine is required. One of the principal barriers to vaccine development against M. tuberculosis is the complexity of the immune response to infection, with uncertainty as to what constitutes an immunological correlate of protection. In this paper, we seek to give an overview of the immunology of M. tuberculosis infection, and by doing so, investigate possible targets of vaccine development. This encompasses the innate, adaptive, mucosal and humoral immune systems. Though MVA85A did not improve protection compared with BCG alone in a large-scale clinical trial, the correlates of protection this has revealed, in addition to promising results from candidate such as VPM1002, M72/ASO1E and H56:IC31 point to a brighter future in the field of TB vaccine development.

中文翻译：

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开发新的结核病疫苗。

结核分枝杆菌仍然是单一传染性生物体导致死亡的主要原因。卡介苗 (BCG) 是针对结核分枝杆菌的标准疫苗，据认为只能预防所有疫苗可预防的结核病死亡的 5%，因此需要替代疫苗。结核分枝杆菌疫苗开发的主要障碍之一是对感染的免疫反应的复杂性，以及保护的免疫相关性的构成存在不确定性。在本文中，我们试图概述结核分枝杆菌感染的免疫学，并通过这样做来研究疫苗开发的可能目标。这包括先天性、适应性、粘膜和体液免疫系统。尽管在大规模临床试验中，与单独使用 BCG 相比，MVA85A 并未改善保护作用，但除了 VPM1002、M72/ASO1E 和 H56:IC31 等候选药物的有希望的结果之外，它还揭示了保护作用的相关性，表明该药物的未来更加光明。结核病疫苗开发领域。