Mycobacterial Diseases
Open Access

Abstract

Vaccines against Mycobacterium Tuberculosis: Exploring Alternate Strategies to Combat a Near-perfect Pathogen

Lionel G Filion, Mohammed N Al-Ahdal and Jason A Tetro

Tuberculosis is a significant threat to human health, infecting nearly one third of the world’s population and causing over a million deaths per year. The need for an effective vaccine against tuberculosis is apparent however, the current vaccine has not been successful neither in the prevention nor recovery from infection. The pathogenesis of the causative agent, Mycobacterium tuberculosis has been extensively studied. The mechanisms of immune evasion and modulation that enable persistence of infection through subclinical latency and eventually active tuberculosis have been partially described. Many of these mechanisms are directly antagonistic to the intended benefit of vaccines, leaving a conundrum that has yet to be resolved. This review will first examine the nature of tuberculosis pathogenesis in the context of the immune response and outline the varied processes utilized by the bacterium to cause modulation. The review will also investigate other vaccination options that may overwhelm these microbial mechanisms or avert them entirely, allowing for the engagement of the immune response and clearance of the bacterium.