The development of a new tuberculosis vaccine is an urgent need due to the failure of the current vaccine, BCG, to protect against the respiratory form of the disease. MTBVAC is an attenuated Mycobacterium tuberculosis vaccine candidate genetically engineered to fulfil the Geneva consensus requirements to enter human clinical trials. We selected a M. tuberculosis clinical isolate to generate two independent deletions without antibiotic-resistance markers in the genes phoP, coding for a transcription factor key for the regulation of M. tuberculosis virulence, and fadD26, essential for the synthesis of the complex lipids phthiocerol dimycocerosates (DIM), one of the major mycobacterial virulence factors. The resultant strain MTBVAC exhibits safety and biodistribution profiles similar to BCG and confers superior protection in preclinical studies. These features have enabled MTBVAC to be the first live attenuated M. tuberculosis vaccine to enter clinical evaluation.

Background Tuberculosis remains one of the world's deadliest transmissible diseases despite the widespread use of BCG. MTBVAC is a new live tuberculosis vaccine based on a genetically attenuated phoP-/fadD26-deletion mutant of M. tuberculosis that expresses most antigens present in human isolates in contrast to BCG. Methods We conducted this randomized, double-blind, controlled phase I study at CHUV, Lausanne, Switzerland, to compare MTBVAC to BCG in healthy, PPD-negative adults. Primary outcome was safety in all vaccinated participants. Secondary outcome included whole blood cell mediated immune response to live MTBVAC and BCG as well as interferon-gamma release assay (IGRA) on peripheral blood mononuclear cells. Volunteers fulfilling the inclusion criteria were randomly allocated (on a 3:1 basis) in a dose-escalation manner to three cohorts. Each cohort included 9 subjects who were injected with MTBVAC 5x10 3 , 5x10 4 , or 5x10 5 colony forming units (CFU) in 0.1 mL and 3 subjects with BCG (single dose of 5x10 5 CFU in 0.1 mL). Each subject received a single intradermal injection in the non-dominant arm starting with the lowest MTBVAC dose. Findings Thirty-six volunteers were recruited. Vaccination with MTBVAC (5x10 3 , 5x10 4 , 5x10 5 CFU/0.1mL) was as safe as with BCG, and did not induce serious adverse events. All individuals were IGRA negative at the end of follow-up (D210). After whole blood stimulation with live MTBVAC or BCG, MTBVAC was immunogenic in a dosedependent manner. At the same dose level as BCG (5x10 5 CFU), although no

Background Infants are a key target population for new tuberculosis vaccines. We assessed the safety and immunogenicity of the live-attenuated Mycobacterium tuberculosis vaccine candidate MTBVAC in adults and infants in a region where transmission of tuberculosis is very high. Methods We did a randomised, double-blind, BCG-controlled, dose-escalation trial at the South African Tuberculosis Vaccine Initiative site near Cape Town, South Africa. Healthy adult community volunteers who were aged 18-50 years, had received BCG vaccination as infants, were HIV negative, had negative interferon-γ release assay (IGRA) results, and had no personal history of tuberculosis or current household contact with someone with tuberculosis were enrolled in a safety cohort. Infants born to HIV-negative women with no personal history of tuberculosis or current household contact with a person with tuberculosis and who were 96 h old or younger, generally healthy, and had not yet received routine BCG vaccination were enrolled in a separate infant cohort. Eligible adults were randomly assigned (1:1) to receive either BCG Vaccine SSI (5 × 10⁵ colony forming units [CFU] of Danish strain 1331 in 0•1 mL diluent) or MTBVAC (5 × 10⁵ CFU in 0•1 mL) intradermally in the deltoid region of the arm. After favourable review of 28-day reactogenicity and safety data in the adult cohort, infants were randomly assigned (1:3) to receive either BCG Vaccine SSI (2•5 × 10⁵ CFU in 0•05 mL diluent) or MTBVAC in three sequential cohorts of increasing MTBVAC dose (2•5 × 10³ CFU, 2•5 × 10⁴ CFU, and 2•5 × 10⁵ CFU in 0•05 mL) intradermally in the deltoid region of the arm. QuantiFERON-TB Gold In-Tube IGRA was done on days 180 and 360. For both randomisations, a pre-prepared block randomisation schedule was used. Participants (and their parents or guardians in the case of infant participants), investigators, and other clinical and laboratory staff were masked to intervention allocation. The primary outcomes, which were all measured in the infant cohort, were solicited and unsolicited local adverse events and serious adverse events until day 360; non-serious systemic adverse events until day 28 and vaccine-specific CD4 and CD8 T-cell responses on days 7, 28, 70, 180, and 360. Secondary outcomes measured in adults were local injection-site and systemic reactions and haematology and biochemistry at study day 7 and 28. Safety analyses and immunogenicity analyses were done in all participants who received a dose of vaccine. This trial is registered with ClinicalTrials.gov, number NCT02729571.

BackgroundBovine purified protein derivative (bPPD) and avian purified protein derivative (aPPD) are widely used for bovine tuberculosis diagnosis. However, little is known about their qualitative and quantitative characteristics, which makes their standardisation difficult. In addition, bPPD can give false-positive tuberculosis results because of sequence homology between Mycobacterium bovis (M. bovis) and M. avium proteins. Thus, the objective of this study was to carry out a proteomic characterisation of bPPD, aPPD and an immunopurified subcomplex from bPPD called P22 in order to identify proteins contributing to cross-reactivity among these three products in tuberculosis diagnosis.MethodsTrypsin digests of bPPD, aPPD and P22 were analysed by nanoscale liquid chromatography-electrospray ionization tandem mass spectrometry. Mice were immunised with bPPD or aPPD, and their serum was tested by indirect ELISA for reactivity against these preparations as well as against P22.ResultsA total of 456 proteins were identified in bPPD, 1019 in aPPD and 118 in P22; 146 of these proteins were shared by bPPD and aPPD, and 43 were present in all three preparations. Candidate proteins that may cause cross-reactivity between bPPD and aPPD were identified based on protein abundance and antigenic propensity. Serum reactivity experiments indicated that P22 may provide greater specificity than bPPD with similar sensitivity for ELISA-type detection of antibodies against M. tuberculosis complex.ConclusionThe subpreparation from bPPD called P22 may be an alternative to bPPD for serodiagnosis of bovine tuberculosis, since it shares fewer proteins with aPPD than bPPD does, reducing risk of cross-reactivity with anti-M. avium antibodies.Electronic supplementary materialThe online version of this article (10.1186/s12014-017-9171-z) contains supplementary material, which is available to authorized users.

Background Serum antibody detection has potential as a complementary diagnostic tool in animal tuberculosis (TB) control, particularly in multi-host systems. The objective of the present study was to assess the specificity (Sp) of an enzyme-linked immunosorbent assay (ELISA) based on the new multiprotein complex P22 for the detection of specific antibodies against the Mycobacterium tuberculosis complex (MTC) in the four most relevant domestic animals acting as MTC hosts: cattle, goat, sheep and pig. We used sera from an officially TB-free (OTF) country, Norway, and from a non-OTF one, Spain. The samples included sera from goats that had been vaccinated against M. avium subsp. paratuberculosis (MAP) and sheep from a herd in which Corynebacterium pseudotuberculosis had been isolated. Results In cattle, the Sp ranged from 92.5 (IC95% 90.7–94) to 99.4% (IC95% 98.3–99.8) depending on the cut-off used and the origin of the samples (Spain or Norway). Sp in cattle (cut-off point 100) was significantly higher ( P < 0.05) for Norwegian samples. By contrast, Sp in goats was consistently low at the 100 cut-off [30.9 (CI95%23.4–39.5)-78% (CI95% 68.9–85)]. A higher cut-off of 150 improved Sp in Norwegian goats [97% (CI95% 91.6–99)], but still yielded a poor Sp of 56.1% (CI95% 47.3–64.6) in Spanish goats. In Norway at the 100 cut-off the Sp was 58.3 (CI95% 42.2–72.9) and 90.6% (CI95% 81–95.6) in MAP vaccinated and non-vaccinated goats, respectively, indicating interference due to MAP vaccination. Sp in sheep was between 94.4 (CI95% 91.7–96.3) and 100% (CI95% 96.3–100) depending on the cut-off and country, and no diagnostic interference due to infection with C. pseudotuberculosis was recorded. Sp in pigs was 100%, regardless the cut-off point applied, and no significant differences were observed between pigs from Norway and from Spain. Conclusions Due to its excellent Sp in pigs and acceptable Sp in cattle and sheep, this ELISA may constitute a suitable option for TB screening at herd level, particularly in OTF-countries.