Current search for a new effective vaccine against tuberculosis involves selected antigens, vectors and adjuvants. These are being evaluated usually by their booster inoculation following priming with Bacillus Calmette-Guerin. The purpose of this article is to point out, that despite being attenuated of virulence, priming with BCG may still involve immune mechanisms, which are not favourable for protection against active disease. It is postulated, that the responsible 'decoy' constituents selected during the evolution of pathogenic tubercle bacilli may be involved in the evasion from bactericidal host resistance and stimulate immune responses of a cytokine phenotype, which lead to the transition from latent closed granulomas to reactivation with infectious lung cavities. The decoy mechanisms appear as favourable for most infected subjects but leading in a minority of cases to pathology which can effectively transmit the infection. It is proposed that construction and development of new vaccine candidates could benefit from avoiding decoy-type immune mechanisms.

中文翻译：

---

结核病疫苗接种需要避免“诱饵”免疫反应

目前对新的有效抗结核疫苗的研究涉及选定的抗原、载体和佐剂。这些通常通过在用卡介苗芽孢杆菌引发后进行加强接种来评估。这篇文章的目的是要指出，尽管毒力减弱，但用 BCG 启动仍可能涉及免疫机制，这不利于预防活动性疾病。据推测，在致病性结核杆菌进化过程中选择的负责任的“诱饵”成分可能参与逃避杀菌宿主抗性并刺激细胞因子表型的免疫反应，从而导致从潜伏的封闭肉芽肿转变为与感染性肺腔。诱饵机制似乎对大多数受感染对象有利，但在少数情况下会导致可有效传播感染的病理学。有人提出，新候选疫苗的构建和开发可以从避免诱饵型免疫机制中受益。