title: The Progress of Therapeutic Vaccination with Regard to Tuberculosis.
abstract: A major problem with tuberculosis (TB) control is the long duration of drug therapy-both for latent and for active TB. Therapeutic vaccination has been postulated to improve this situation, and to this end there are several candidates already in clinical phases of development. These candidates follow two main designs, namely bacilli-directed therapy based on inactivated -whole or -fragmented bacillus (Mycobacterium wand RUTI) or fusion proteins that integrate non-replicating bacilli -related antigens (H56 vaccine), and host-directed therapy to reduce the tissue destruction. The administration of inactivatedMycobacterium vaccaeprevents the "Koch phenomenon" response, and oral administration of heat-killedMycobacterium manresensisprevents excessive neutrophilic infiltration of the lesions. This review also tries to explain the success ofMycobacterium tuberculosisby reviewing its evolution from infection to disease, and highlights the lack of a definitive understanding of the natural history of TB pathology and the need to improve our knowledge on TB immunology and pathogenesis.
authors.affiliation: Unitat de Tuberculosi Experimental, Universitat Autònoma de Barcelona, CIBERES, Fundació Institut Germans Trias i Pujol Badalona, Spain.
authors.forename: Pere-Joan
authors.initials: PJ
authors.lastname: Cardona
keywords: H56; Mycobacterium indicus pranii; Mycobacterium manresensis; Mycobacterium tuberculosis; Mycobacterium vaccae; Mycobacterium w; neutrophils; vaccines