title: The search for a tuberculosis vaccine: an elusive quest?
abstract: The precise mechanisms of protective immunity and pathogenesis of tuberculosis (TB) are poorly understood. Yet, many efforts are underway to develop new, more effective vaccines against Mycobacterium tuberculosis. This development appears to be predicated upon the assumption that natural acquired immunity to TB exists. In this paper we review the evidence for such immunity, explore the hypothesis that disease progression is due to some, often transient, immunological dysfunction, and discuss its relevance for vaccine development. Several mechanisms for such an immune dysfunction are proposed, including the recently suggested involvement of viral co-infections. Developing vaccines for such co-infections may be a new challenge for TB control.
authors.affiliation: Department of Community Medicine, United Arab Emirates University, P.O. Box 17666 Al Ain, United Arab Emirates. nico.nagelkerke@gmail.com
authors.forename: Nico J D
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: Sake J
authors.initials: SJ
authors.lastname: de Vlas
authors.forename: Yodi
authors.initials: Y
authors.lastname: Mahendradhata
authors.forename: Tom H M
authors.initials: TH
authors.lastname: Ottenhoff
authors.forename: Martien
authors.initials: M
authors.lastname: Borgdorff
mesh_terms: D003140:Communicable Disease Control; D015195:Drug Design; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D014376:Tuberculosis / Q000517:prevention & control*; D032581:Tuberculosis Vaccines / Q000276:immunology*
chemical_list: D032581:Tuberculosis Vaccines