IL-4 in tuberculosis: implications for vaccine design.
Current attempts to find a vaccine for tuberculosis (TB) are based on the assumption that it must drive a Th1 response. We review the evidence that progressive disease might not be due to absence of Th1, but rather to the subversive effect of an unusual Th2-like response, involving interleukin-4 (IL-4) and IL-4delta2. This Th2-like response can impair bactericidal function and lead to toxicity of tumour necrosis factor-alpha (TNF-alpha) and to pulmonary fibrosis. If this is important, effective vaccines will need to suppress pre-existing Th2-like activity. Such vaccines are feasible and are active therapeutically in mouse TB.
Rook
Graham A W
GA
Centre for Infectious Diseases and International Health, Windeyer Institute for Medical Sciences, Royal Free and University College Medical School, 46 Cleveland Street, London, UK. g.rook@ucl.ac.uk
Hernandez-Pando
Rogelio
R
Dheda
Keertan
K
Teng Seah
Geok
G
D000818:Animals; D001500:BCG Vaccine / Q000627:therapeutic use; D006801:Humans; D015847:Interleukin-4 / Q000276:immunology*; D014376:Tuberculosis / Q000188:drug therapy* / Q000276:immunology*; D014612:Vaccines / Q000627:therapeutic use*
D001500:BCG Vaccine; D014612:Vaccines; D015847:Interleukin-4