title: Targeting multidrug-resistant tuberculosis (MDR-TB) by therapeutic vaccines.
abstract: Tuberculosis (TB) has scourged humankind for millennia, and latent infection affects nearly one-third of today's world population. The emergence of multidrug-resistant (MDR)-TB is a major global threat and reflects treatment failure of drug-sensitive disease. MDR-TB management is a burden for patients and society; success rates are unacceptably low with prolonged treatment duration. Mycobacterium tuberculosis (Mtb) possesses the ability to transform into a dormant state in which it can persist in the face of antimicrobial treatment and host defense. This sub-population of persisters is largely responsible for lengthy and difficult treatment. Targeting persistent bacilli could eventually improve the treatment success rate (currently 50-65 %) and shorten duration of treatment. A subset of therapies in the pipeline, termed therapeutic vaccines, use the host immune response to attack Mtb. The historical occurrence of an exacerbated host response has resulted in a negative perception of therapeutic vaccines. Thus, a renewed concept of immunotherapy is needed. We review current perspectives of immunotherapy in MDR-TB based on the knowledge of TB immunology and briefly discuss the profiles of several therapeutic vaccine products.
authors.affiliation: Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Satria A
authors.initials: SA
authors.lastname: Prabowo
authors.forename: Matthias I
authors.initials: MI
authors.lastname: Gröschel
authors.forename: Ed D L
authors.initials: ED
authors.lastname: Schmidt
authors.forename: Alena
authors.initials: A
authors.lastname: Skrahina
authors.forename: Traian
authors.initials: T
authors.lastname: Mihaescu
authors.forename: Serap
authors.initials: S
authors.lastname: Hastürk
authors.forename: Rotislav
authors.initials: R
authors.lastname: Mitrofanov
authors.forename: Edita
authors.initials: E
authors.lastname: Pimkina
authors.forename: Ildikó
authors.initials: I
authors.lastname: Visontai
authors.forename: Bouke
authors.initials: B
authors.lastname: de Jong
authors.forename: John L
authors.initials: JL
authors.lastname: Stanford
authors.forename: Père-Joan
authors.initials: PJ
authors.lastname: Cardona
authors.forename: Stefan H E
authors.initials: SH
authors.lastname: Kaufmann
authors.forename: Tjip S
authors.initials: TS
authors.lastname: van der Werf
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D054908:Extensively Drug-Resistant Tuberculosis / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007167:Immunotherapy; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D012307:Risk Factors; D032581:Tuberculosis Vaccines / Q000276:immunology* / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control* / Q000628:therapy
chemical_list: D000995:Antitubercular Agents; D032581:Tuberculosis Vaccines