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01 Jun, 2019
Recent Advancements in the Development of Tuberculosis Vaccine
Tuberculosis (TB) is the most common infectious cause of death in the world. About a third of the world’s population is affected by TB. According to the world health organization (WHO), an estimated 10 million new cases of TB were detected in 2017 amongst which 27% cases were in India. The goal of WHO’s End TB Strategy is to bring about a 95% reduction in TB mortality and a 90% reduction in TB incidence by 2035. With the increasing emergence of multidrug-resistant TB and extensively-drug resistant TB, the development of new TB vaccines has become pivotal to achieve these goals.

Currently, Bacille Calmette Guerin (BCG) is the only Food and Drug Administration (FDA) approved vaccine against TB. However, major drawbacks such as inconsistent efficacy against pulmonary TB, especially in adults and adolescents and contraindication in HIV exposed infants have increased the need to develop new vaccines. A number of hurdles have to be overcome to pave the way for developing TB vaccines. As of 2018, about 22 vaccine candidates are included in the Clinical and preclinical TB vaccine pipeline in varying stages of development. Out of these 22 vaccine candidates, about 14 vaccine candidates are currently in clinical trials. A Chinese candidate Vaccae is the only vaccine candidate that has entered phase 3 of clinical testing. A phase 2b clinical trial involving M72/AS01E vaccine candidate showed a 54 % protection against pulmonary tuberculosis over a period of 2 years. Phase 2 trials on the safety and immunogenicity of this vaccine candidate are ongoing. This clinical trial demonstrates that there is tremendous scope for curbing TB with the development of new TB vaccines as there is a potential to overcome the limitation of the BCG vaccine.

A major downside of many vaccines is that a temperature controlled system is required during transport to maintain the efficacy of the vaccine, which can be costly. A thermostable vaccine candidate is being developed by scientists at the Infectious Disease Research Institute (IDRI) in Seattle to overcome this drawback. These scientists are developing a freeze-dried powder formulation of ID93 recombinant vaccine candidate which has been shown to be safe and immunogenic in a Phase 2a clinical trial. Investigations are being carried out to determine the efficacy of the product made by combining sterile water with a single vial containing freeze-dried ID93 and an adjuvant GLA-SE (an immune response-stimulating protein).

A collaborative approach between researchers and the government is the need of the hour as adequate funding is required to carry out these researches. Hopefully, a new vaccine becomes available in the near future to curb the menace called TB.





References:

1. https://www.who.int/immunization/research/development/tuberculosis/en/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530405/

3. https://www.nih.gov/news-events/news-releases/temperature-stable-experimental-tuberculosis-vaccine-enters-clinical-testing

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