Importance of adjuvant selection in tuberculosis vaccine development: Exploring basic mechanisms and clinical...

Area of Science:

• Immunology
• Vaccinology
• Infectious Diseases

Background:

• Tuberculosis (TB) remains a significant global health threat, with the existing Bacillus Calmette-Guérin (BCG) vaccine showing unsatisfactory efficacy against pulmonary infections in adults.
• The emergence of SARS-CoV-2 highlighted the critical role of vaccines in controlling infectious diseases.

Purpose of the Study:

• To review the pivotal roles and mechanisms of adjuvants in developing effective tuberculosis vaccines.
• To explore prospects for novel adjuvants and combinations tailored for diverse populations, including the elderly and those with comorbidities.

Main Methods:

• Literature review focusing on adjuvant mechanisms and their impact on vaccine efficacy and safety.
• Analysis of immunological alterations in aging, HIV co-infection, and diabetes relevant to vaccine responses.

Main Results:

• Adjuvants are essential for modulating optimal immunological responses, enhancing antigen presentation and immune signaling for vaccine candidates.
• Subunit vaccines incorporating specialized adjuvants show promising clinical outcomes for TB prevention.

Conclusions:

• Adjuvants are critical for optimizing both the efficacy and safety of new TB vaccines.
• Future research should focus on developing tailored adjuvant strategies for specific populations to address TB's global burden.