Front Immunol. 2017 Apr 5;8:407. doi: 10.3389/fimmu.2017.00407. eCollection 2017.

Moliva JI1, Turner J1,2, Torrelles JB1,2.

Abstract
Mycobacterium tuberculosis (M.tb), the causative agent of tuberculosis (TB), is the current leading cause of death due to a single infectious organism. Although curable, the broad emergence of multi-, extensive-, extreme-, and total-drug resistant strains of M.tb has hindered eradication efforts of this pathogen. Furthermore, computational models predict a quarter of the world’s population is infected with M.tb in a latent state, effectively serving as the largest reservoir for any human pathogen with the ability to cause significant morbidity and mortality. The World Health Organization has prioritized new strategies for improved vaccination programs; however, the lack of understanding of mycobacterial immunity has made it difficult to develop new successful vaccines. Currently, Mycobacterium bovis bacillus Calmette-Guérin (BCG) is the only vaccine approved for use to prevent TB. BCG is highly efficacious at preventing meningeal and miliary TB, but is at best 60% effective against the development of pulmonary TB in adults and wanes as we age. In this review, we provide a detailed summary on the innate immune response of macrophages, dendritic cells, and neutrophils in response to BCG vaccination. Additionally, we discuss adaptive immune responses generated by BCG vaccination, emphasizing their specific contributions to mycobacterial immunity. The success of future vaccines against TB will directly depend on our understanding of mycobacterial immunity.

Güncel Pediatri 2005 ; 2 : 37-39

BCG aşısının özellikleri
• Pozitif özellikler
1. Yenidoğanın aşılanması çoçukluk çağı tüberkülozunda hem
hastalığa hem de ölüme karşı etkilidir.
2. Aşılama miliyer tüberküloza veya tüberküloz menenjite karşı etkilidir.
3. Yenidoğanın aşılanması tüberküloz dışı lenfadenit ve lepraya karşı da koruyucudur.
4. Maliyet düşüktür.
• Negatif özellikler
1. Lisanslı aşıların gücündeki farklılıklar
2. Çocuk ve erişkindeki mikobakteri infeksiyonlarında sınırlı etkinlik
3. Hastalıktan koruma işaretleyicilerinin yokluğu
4. Aşı reaksiyonlarının sıklığı ve süresi
5. Sağlıklı olanlarda da BCG adeniti ve osteomiyelit riski
6. HIV’li olanlarda dissemine BCG
7. Pekiştirme (booster) etkisinin yokluğu
8. Parenteral uygulama
9. Tüberkülin deri reaksiyonuna etkisi
• Bilinmeyen özellikler
1. Etki süresi
2. HIV infeksiyonunda pulmoner ve bakteremik tüberküloz
hastalığına karşı etkinliği