Sequential immunization with mycobacterial antigen Ag85B-expressing DNA and Mycobacterium bovis bacille Calmette-Guerin (BCG) was more effective than BCG immunization in protecting against Mycobacterium tuberculosis infection. Depletion of the CD8 ؉ T cells in the immunized mice impaired protection in their spleens, indicating that this improved efficacy was partially mediated by CD8 ؉ T cells.
Tuberculosis (TB) kills 2 million individuals per year and is the greatest cause of death by a single bacterial agent (26). The worldwide incidence of TB continues to rise (26), due in part to the variable efficacy displayed by the only registered vaccine for human use, Mycobacterium bovis bacillus Calmette-Guérin (BCG) (10). This has fuelled the search for more effective anti-TB vaccines, and approaches ranging from DNA vaccines to live, attenuated strains of Mycobacterium tuberculosis have been assessed; the majority of these approaches have failed to deliver improved protective efficacy compared to BCG in animal models (5). A small number of vaccines have recently entered human trials, two of which aim to improve expansion of T cells directed against a single member of the M. tuberculosis antigen 85 (Ag85) complex (15,24). While these two approaches have shown promise in animal models and initial testing in humans, the fact that no single mycobacterial antigen is recognized by all M. tuberculosis-infected individuals (32) may limit the breadth of coverage delivered by these vaccines within the human population.One approach to improve anti-TB vaccination is to target components of the immune response required for optimal protective efficacy. We have previously demonstrated that vaccination strategies designed to augment gamma interferon (IFN-␥) production, such as codelivery of the cytokines interleukin-12 (IL-12) and IL-23 during DNA vaccination, significantly improve protection against TB (29, 39). IL-12 is critical for the induction of Th1-like CD4 ϩ cells, and humans and mice lacking the p40 chain of IL-12 or its receptors are highly susceptible to M. tuberculosis infection (2, 6, 8). M. tuberculosis infection of either murine or human dendritic cells (DCs), but not macrophages, polarizes naïve T cells to the Th1 phenotype due to production of 14). Infection of mice with BCG and subsequent analysis of DC and macrophage populations revealed that DCs exclusively produced IL-12 and presented antigen to T cells (17). After aerosol infection of mice with M. tuberculosis it was observed that DCs, and not macrophages, migrated specifically to the draining lymph nodes (DLNs) and initiated primary Th1 responses (4). These results indicate that DCs play a pivotal role in priming the adaptive immune response to counter infection with M. tuberculosis. It is possible that limited numbers of DCs at the site of antigen production is one factor hindering development of vaccines against diseases such as TB which are reliant on optimal priming of T-cell responses.The Fms-like tyrosine kinase 3 ligand (Flt3L) influences the development of multiple hematopoietic lineages, in particular DCs (23). Administration of soluble Flt3L to both mice (21) and humans (22) increases the numbers of DCs in secondary lymphoid organs and blood. We therefore reasoned that codelivery of Flt3L may be a feasible strategy to improve the efficacy of anti-TB vaccines. In this report, we demonstrate that Flt3L, delivered as plasmid DNA fused to the d...
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