2016
DOI: 10.1038/nri.2016.43
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Harnessing the beneficial heterologous effects of vaccination

Abstract: Clinical evidence strongly suggests that certain live vaccines, in particular Bacille Calmette–Guérin (BCG) and measles vaccines, can reduce all-cause mortality, likely via protection against non-targeted pathogens in addition to the targeted pathogen. The underlying mechanisms are currently unknown. We discuss how heterologous lymphocyte activation and innate immune memory could promote protection beyond the intended target pathogen and consider how vaccinologists could leverage heterologous immunity to impro… Show more

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Cited by 222 publications
(187 citation statements)
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“…Finally, recent studies have demonstrated that monocyte and macrophage function can be modified for extended periods following microbial exposure due to metabolic and epigenetic changes (“trained immunity” or “innate immune memory”), which can confer long-term, lymphocyte-independent protection against pathogens and may underlie some clinical observations of heterologous effects of vaccination, especially in infants (Goodridge et al, 2016). These effects are likely maintained by epigenetic modification of myeloid progenitors (and even HSCs), as well as long-lived tissue-resident macrophages.…”
Section: Discussionmentioning
confidence: 99%
“…Finally, recent studies have demonstrated that monocyte and macrophage function can be modified for extended periods following microbial exposure due to metabolic and epigenetic changes (“trained immunity” or “innate immune memory”), which can confer long-term, lymphocyte-independent protection against pathogens and may underlie some clinical observations of heterologous effects of vaccination, especially in infants (Goodridge et al, 2016). These effects are likely maintained by epigenetic modification of myeloid progenitors (and even HSCs), as well as long-lived tissue-resident macrophages.…”
Section: Discussionmentioning
confidence: 99%
“…To this end, monocytes and macrophages that are exposed to certain stimuli can develop metabolic and epigenetic changes that lead to long-term alterations in subsequent responses by these cells. To further highlight their versatility, the memory established in monocytes and macrophages can be stimulatory or suppressive, with both effects often occurring simultaneously, depending on which genes are expressed or suppressed [57]. The process of macrophage “priming” or “training” occurs when prior exposure to a specific stimulus induces an enhanced immune response, such as increased microbicidal activity (i.e., increased phagocytic activity and increased expression of pro-inflammatory genes) [58].…”
Section: Text Of the Reviewmentioning
confidence: 99%
“…A large majority of these studies involve either short TAA-derived peptides that can directly bind to MHC Class I or II molecules expressed by antigen-presenting cells 176 (42 studies), or SLPs that are processed intracellularly and then loaded on MHC Class I or II molecules 172,177,178 (22 studies), most often in combination with immunological adjuvants 179-182 like montanide ISA-51 (water-in-oil emulsion) 181,183 Hiltonol® (poly- L -lysine in carboxymethylcellulose, a TLR3 ligand) 184 and GM-CSF. 183,185-187 In several instances, vaccination is further combined with standard treatment regimens including conventional chemotherapy, 117,188-191 radiation therapy, 52,192-195 and targeted anticancer agents, 196-199 or with various immunotherapeutic interventions.…”
Section: Ongoing Clinical Trialsmentioning
confidence: 99%