Vaccines for Leprosy and Tuberculosis: Opportunities for Shared Research, Development and Application
- 1Leiden University Medical Center, Netherlands
- 2The National Hansen's Disease Programs, United States
- 3The Leprosy Mission Canada, Canada
Tuberculosis (TB) and leprosy still represent significant public health challenges, especially in low- and lower-middle-income countries. Both poverty-related mycobacterial diseases require better tools to improve disease control. For leprosy, there has been an increased emphasis on developing tools for improved detection of infection and early phases of disease. For TB, there has been a similar emphasis on such diagnostic tests, while increased research efforts have also focussed on the development of new vaccines. BCG (Bacille Calmette-Guérin), the only available TB-vaccine, provides insufficient and inconsistent protection to pulmonary TB in adults. The impact of BCG on leprosy, however, is significant, and the introduction of new TB vaccines that might replace BCG could, therefore, have serious impact also on leprosy. Given the similarities in antigenic makeup between the pathogens M. tuberculosis (Mtb) and M. leprae, it is well possible, however, that new TB vaccines could cross-protect against leprosy. New TB subunit vaccines currently evaluated in human phase I and II studies indeed often contain antigens with homologues in M. leprae. In this review, we discuss pre-clinical studies and clinical trials of sub-unit or whole mycobacterial vaccines for TB and leprosy and reflect on the development of vaccines that could provide protection against both diseases. Furthermore, we provide the first preclinical evidence of such cross-protection by Ag85B (Mtb Antigen 85B)-ESAT6 (Early Secretory Antigenic Target) fusion recombinant proteins in in vivo mouse models of Mtb and M. leprae infection. We propose that preclinical integration and harmonization of TB and leprosy research should be considered and included in global strategies with respect to cross-protective vaccine research and development.
Keywords: Ag85B, ESAT6, Mycobacterium leprae (M. leprae), Mycobacterium tuberculosis (MTB), tuberculosis (TB), Leprosy, hybrid recombinant protein, Vaccines
Received: 09 Nov 2017;
Accepted: 05 Feb 2018.
Edited by:Steffen Stenger, Universitätsklinikum Ulm, Germany
Reviewed by:Elsa Anes, Faculdade de Farmácia, Universidade de Lisboa, Portugal
Maria F. Quiroga, Universidad de Buenos Aires. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS). Facultad de Medicina., Argentina
Copyright: © 2018 Coppola, van den Eeden, Robbins, Wilson, Franken, Adams, Gillis, Ottenhoff and Geluk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: MD. Mariateresa Coppola, Leiden University Medical Center, Leiden, Netherlands, email@example.com