       Document 0484
 DOCN  M9610484
 TI    [Immunization against tuberculosis: new vaccination strategies or is
       there an alternative to BCG?]
 DT    9601
 AU    Kaufman SH; Abteilung fur Immunologie, Universitat Ulm.
 SO    Immun Infekt. 1995 Aug;23(4):119-24. Unique Identifier : AIDSLINE
       MED/96015942
 AB    Consistently high tuberculosis rates in many developing nations, the
       surprising increase in tuberculosis cases in numerous industrialized
       countries, together with the emergence of multi-drug-resistant strains
       of Mycobacterium tuberculosis have sharpened public interest in this
       ancient scourge. Improved tuberculosis control could best be achieved by
       an efficacious vaccine. The available attenuated vaccine strain,
       Mycobacterium bovis BCG, has only limited efficiency. This vaccine is
       capable of protecting against disseminated miliary tuberculosis in the
       newborn, but it is unable to prevent stable infection and to cause
       sterile pathogen eradication. Hence, adult tuberculosis, representing
       the majority of all tuberculosis cases, is not preventable by BCG
       vaccination. Due to the extraordinarily high rate of asymptomatic M.
       tuberculosis infection (1/3 of the total world population) any novel
       vaccination strategy has to fulfil two major tasks: first, prevention of
       stable infection, second, eradication of already established infection.
       T lymphocytes represent the major target for any vaccine strategy,
       because they serve as central mediators of acquired immunity. They
       segregate into distinct populations, characterized by different
       activation conditions and biological functions. These T cell populations
       do not act independently from, but rather interact with, each other
       mostly through cytokines. Although CD4 T lymphocytes of T helper 1 type
       are essential for protection, CD8 T cells expressing cytolytic functions
       are required, in addition. Perhaps other T cell populations, such as
       gamma/delta T cells and double negative alpha/beta T cells, also
       participate. An effective vaccine has to stimulate the precise
       combination of T cells and cytokines required for the different tasks.
       It remains to be clarified in how far this can be achieved by a single
       vaccine.
 DE    Adult  Antibodies, Bacterial/IMMUNOLOGY  BCG Vaccine/*THERAPEUTIC USE
       CD4-Positive T-Lymphocytes/IMMUNOLOGY  CD8-Positive
       T-Lymphocytes/IMMUNOLOGY  English Abstract  Forecasting  Human  HIV
       Infections/COMPLICATIONS  Immunity, Cellular  Intestinal
       Mucosa/IMMUNOLOGY  Receptors, Antigen, T-Cell, alpha-beta/METABOLISM
       Receptors, Antigen, T-Cell, gamma-delta/METABOLISM  T-Lymphocyte
       Subsets/IMMUNOLOGY  Th1 Cells/IMMUNOLOGY
       Tuberculosis/EPIDEMIOLOGY/IMMUNOLOGY/*PREVENTION & CONTROL  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

