REPORT

Clinical aspects

New issues in tuberculosis

S H E Kaufmann

Correspondence to:
Correspondence to:
Professor S H E Kaufmann
Max Planck Institute for Infection Biology, Department of Immunology, Schumannstr, 21-22, 10117 Berlin, Germany; kaufmann{at}mpiib-berlin.mpg.de

Tuberculosis remains a major health problem worldwide. The disease is caused by Mycobacteriumtuberculosis whose preferred habitat is the host macrophage. The immune response against tuberculosis is mediated by different subsets of T cells including both conventional CD4 and CD8 T cells as well as unconventional CD1 restricted and T cells. The CD1 restricted T cells are particularly remarkable because they recognise the glycolipids abundant in the mycobacterial cell wall. Although a vaccine, M.bovis BCG, is available which protects toddlers against miliary tuberculosis, it is ineffective in preventing pulmonary tuberculosis in adults. Therefore, a novel vaccine is urgently required. Knowledge about the functioning of different T cell populations during infection and disease provides the basis for rational vaccine design. We have constructed a recombinant BCG vaccine which, compared with wild-type BCG, induces superior protection not only against laboratory strains but also against clinical isolates of M. tuberculosis.

Abbreviations: BCG, bacille Calmette Guérin; hly, listeriolysin; MDR, multidrug resistance; MHC, major histocompatibility complex

Keywords: tuberculosis; Mycobacterium tuberculosis; vaccine design; BCG vaccine; phagosome maturation; macrophages; T cell; major histocompatibility complex

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