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Systemic BCG Immunization Induces Persistent Lung Mucosal Multifunctional CD4 TEM Cells which Expand Following Virulent Mycobacterial Challenge (Paper)

Tuberculosis (TB) caused by infection with Mycobacterium tuberculosis or Mycobacterium bovis remains one of the most important infectious diseases of man and animals respectively, and continues to inflict a huge cost in humans and animals in both health and financial terms.

At present the only available vaccine against TB is M. bovis bacille Calmette-Guérin (BCG) which demonstrates variable efficacy in humans and cattle. In particular, BCG induces effective protection against childhood disseminated TB and tuberculous meningitis, but poor protection against pulmonary TB in adolescents and adults. Despite this inconsistent performance, BCG remains the most widely used human vaccine in the world and due to its partial efficacy and proven safety record, is unlikely to be withdrawn. Hence, a great deal of research effort is targeted toward improving the efficacy of BCG by a number of approaches; prominent among which is boosting BCG with heterologous vaccines.

A deeper understanding of the T cell mechanisms underpinning the immunity induced by BCG vaccination would help to identify immune correlates of protection. This would facilitate and accelerate the rational design of improved replacement, or adjunct tuberculosis vaccines.

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