Prevention of tuberculosis in macaques after intravenous BCG immunization
Author(s)
Darrah, Patricia A.; Zeppa, Joseph J.; Maiello, Pauline; Hackney, Joshua A.; Wadsworth, Marc Havens; Hughes, Travis K.; Pokkali, Supriya; Swanson II, Phillip A.; Grant, Nicole L.; Rodgers, Mark A.; Kamath, Megha; Causgrove, Chelsea M.; Laddy, Dominick J.; Bonavia, Aurelio; Casimiro, Danilo; Lin, Philana Ling; Klein, Edwin; White, Alexander G.; Scanga, Charles A.; Shalek, Alexander K; Roederer, Mario; Flynn, JoAnne L.; Seder, Robert A.; ... Show more Show less
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Mycobacterium tuberculosis (Mtb) is the leading cause of death from infection worldwide1. The only available vaccine, BCG (Bacillus Calmette–Guérin), is given intradermally and has variable efficacy against pulmonary tuberculosis, the major cause of mortality and disease transmission1,2. Here we show that intravenous administration of BCG profoundly alters the protective outcome of Mtb challenge in non-human primates (Macaca mulatta). Compared with intradermal or aerosol delivery, intravenous immunization induced substantially more antigen-responsive CD4 and CD8 T cell responses in blood, spleen, bronchoalveolar lavage and lung lymph nodes. Moreover, intravenous immunization induced a high frequency of antigen-responsive T cells across all lung parenchymal tissues. Six months after BCG vaccination, macaques were challenged with virulent Mtb. Notably, nine out of ten macaques that received intravenous BCG vaccination were highly protected, with six macaques showing no detectable levels of infection, as determined by positron emission tomography–computed tomography imaging, mycobacterial growth, pathology and granuloma formation. The finding that intravenous BCG prevents or substantially limits Mtb infection in highly susceptible rhesus macaques has important implications for vaccine delivery and clinical development, and provides a model for defining immune correlates and mechanisms of vaccine-elicited protection against tuberculosis.
Date issued
2020-01Department
Massachusetts Institute of Technology. Department of Chemistry; Massachusetts Institute of Technology. Institute for Medical Engineering & Science; Koch Institute for Integrative Cancer Research at MITJournal
Nature
Publisher
Springer Science and Business Media LLC
Citation
Darrah, Patricia A. et al. "Prevention of tuberculosis in macaques after intravenous BCG immunization." Nature 577, 7788 (January 2020): 95–102 © 2020 The Author(s)
Version: Final published version
ISSN
1476-4687