title: Antibodies and tuberculosis.
abstract: Tuberculosis (TB) remains a major public health problem internationally, causing 9.6 million new cases and 1.5 million deaths worldwide in 2014. The Bacillus Calmette-Guérin vaccine is the only licensed vaccine against TB, but its protective effect does not extend to controlling the development of infectious pulmonary disease in adults. The development of a more effective vaccine against TB is therefore a pressing need for global health. Although it is established that cell-mediated immunity is necessary for the control of latent infection, the presupposition that such immunity is sufficient for vaccine-induced protection has recently been challenged. A greater understanding of protective immunity against TB is required to guide future vaccine strategies against TB. In contrast to cell-mediated immunity, the human antibody response against M.tb is conventionally thought to exert little immune control over the course of infection. Humoral responses are prominent during active TB disease, and have even been postulated to contribute to immunopathology. However, there is evidence to suggest that specific antibodies may limit the dissemination of M.tb, and potentially also play a role in prevention of infection via mucosal immunity. Further, antibodies are now understood to confer protection against a range of intracellular pathogens by modulating immunity via Fc-receptor mediated phagocytosis. In this review, we will explore the evidence that antibody-mediated immunity could be reconsidered in the search for new vaccine strategies against TB.
authors.affiliation: Department of Medicine, Imperial College London, W2 1PG, United Kingdom; Clinical Infectious Diseases Research Initiative and Department of Medicine, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa. Electronic address: ashley.jacobs@imperial.ac.uk.
authors.forename: Ashley J
authors.initials: AJ
authors.lastname: Jacobs
authors.affiliation: Department of Medicine, Imperial College London, W2 1PG, United Kingdom.
authors.forename: Juthathip
authors.initials: J
authors.lastname: Mongkolsapaya
authors.affiliation: Department of Medicine, Imperial College London, W2 1PG, United Kingdom.
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Screaton
authors.affiliation: The Jenner Institute, University of Oxford, OX3 7DQ, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: McShane
authors.affiliation: Department of Medicine, Imperial College London, W2 1PG, United Kingdom; Clinical Infectious Diseases Research Initiative and Department of Medicine, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa; The Francis Crick Institute, London NW1 2AT, United Kingdom.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wilkinson
mesh_terms: D000818:Animals; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000276:immunology; D001500:BCG Vaccine / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D018928:Immunity, Mucosal; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D014376:Tuberculosis / Q000276:immunology / Q000517:prevention & control*; D032581:Tuberculosis Vaccines / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D000911:Antibodies, Monoclonal; D001500:BCG Vaccine; D032581:Tuberculosis Vaccines
keywords: Antibodies; Humoral immunity; Tuberculosis; Vaccine