Accelerating tuberculosis vaccine trials with diagnostic and prognostic biomarkers

ABSTRACT

Introduction: The most recent estimates on tuberculosis (TB) morbidity and mortality reveal that the global disease burden is even higher than previously assumed. Better drugs, diagnostics and vaccines are major requirements to control the ongoing TB pandemic. The high complexity of the infectious process and the underlying pathology, however, challenge elucidation of protective immune mechanisms at the various stages towards active TB disease, which need to be understood for rational design of novel intervention measures.

Areas covered: Next to the more classical approaches, host biomarkers increasingly receive attention as promising tools on our way to control the disease. In the area of diagnosis, host biomarkers are recognized as promising new means because the identification of small biosignatures with high discriminatory and even prognostic potential has stimulated the hope that rapid and easy-to-perform diagnosis and prognosis will become possible in the near future. For rational design of new vaccine candidates, correlates of protection are highly desirable. High-throughput systems-vaccinology will boost the identification of such biomarker profiles.

Expert commentary: Considering their potential to accelerate development of better diagnostics and vaccines, host biomarkers should be firmly integrated into future TB research.

KEYWORDS:

• Biomarkers
• clinical TB
• diagnostic markers
• prognostic markers
• subclinical TB
• tuberculosis
• vaccine design

Acknowledgments

The excellent editorial help of Mary Louise Grossman, Souraya Sibaei and Katja Grunow is gratefully acknowledged.

Declaration of interest

S.H.E Kaufman is a co-inventor of the TB vaccine candidate VPM1002. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

Work in the authors’ lab is supported by EU FP7 project ‘ADITEC’ (HEALTH-F4-2011-280873), EU Horizon 2020 ‘TBVAC 2020’ (Grant No 643381), EU FP7 project ‘TANDEM’ (HEALTH-F3-2012-305279), BMBF ‘inVAC’ (Grant No. 03ZZ0806A), ‘BioVacSafe’ (IMI JU Grant No. 115308) and ‘PreDiCT-TB’ (IMI JU Grant No. 115337).