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.
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
Graham A W
GA
Rook
Rogelio
R
Hernandez-Pando
Keertan
K
Dheda
Geok
G
Teng Seah
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