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Targeting multidrug-resistant tuberculosis (MDR-TB) by therapeutic vaccines

2012; Springer Science+Business Media; Volume: 202; Issue: 2 Linguagem: Inglês

10.1007/s00430-012-0278-6

1432-1831

Satria A. Prabowo, Matthias I. Gröschel, E.D. Schmidt, Alena Skrahina, T Mihăescu, Serap Hastürk, Rotislav Mitrofanov, Edita Pimkina, Ildikó Visontai, Bouke C. de Jong, J.L. Stanford, Pere‐Joan Cardona, Stefan H. E. Kaufmann, Tjip S. van der Werf,

Cancer therapeutics and mechanisms

Tuberculosis (TB) has scourged humankind for millennia, and latent infection affects nearly one-third of today's world population. The emergence of multidrug-resistant (MDR)-TB is a major global threat and reflects treatment failure of drug-sensitive disease. MDR-TB management is a burden for patients and society; success rates are unacceptably low with prolonged treatment duration. Mycobacterium tuberculosis (Mtb) possesses the ability to transform into a dormant state in which it can persist in the face of antimicrobial treatment and host defense. This sub-population of persisters is largely responsible for lengthy and difficult treatment. Targeting persistent bacilli could eventually improve the treatment success rate (currently 50-65 %) and shorten duration of treatment. A subset of therapies in the pipeline, termed therapeutic vaccines, use the host immune response to attack Mtb. The historical occurrence of an exacerbated host response has resulted in a negative perception of therapeutic vaccines. Thus, a renewed concept of immunotherapy is needed. We review current perspectives of immunotherapy in MDR-TB based on the knowledge of TB immunology and briefly discuss the profiles of several therapeutic vaccine products.