Zusammenfassung
Auch 125 Jahre nach der Entdeckung des Tuberkuloseerregers Mycobacterium tuberculosis durch Robert Koch stellt die Tuberkulose weltweit ein Gesundheitsproblem dar, das die WHO als global emergency, als globalen Notfall, einstuft. Eine hohe Durchseuchungsrate mit M. tuberculosis, das im Wirtsorganismus so lange persistiert, bis ihm ein geschwächtes Abwehrsystem die Gelegenheit zur Ausbreitung bietet, und eine aufwendige und kostenintensive Chemotherapie machen die Entwicklung eines geeigneten Impfstoffs dringend erforderlich. Hinzu kommen steigende Raten an multiresistenter Tuberkulose, v. a. in den Nachfolgestaaten der Sowjetunion und in China. Da seit Jahrzehnten kein neues Tuberkulosemedikament mehr zugelassen wurde, um dieser Entwicklung wirksam zu begegnen, besteht auch hier ein enormer Nachholbedarf. Im Folgenden wird die Immunabwehr bei der Tuberkulose vorgestellt, aus der sich verschiedene Strategien und Ansatzpunkte zur Impfstoffentwicklung ergeben und die zu einem besseren Verständnis der Infektionserkrankung Tuberkulose und ihrer Besonderheiten dienen soll. Die Entwicklung neuer Impfstoffkandidaten ist auf einem guten Weg. Dank internationaler Förderung stehen einige Kandidaten bereits kurz vor der klinischen Testung.
Abstract
Even 125 year after the discovery of Mycobacterium tuberculosis as the aetiological agent of tuberculosis by Robert Koch, tuberculosis is still a global health emergency according to WHO. The high infection rate with M. tuberculosis that persists in the human host until a weakened host immune system allows a reactivation and complicated and expensive antituberculous chemotherapy urgently demand the development of new vaccines. Increasing numbers of multidrug-resistant tuberculosis, especially in the successor states of the former Soviet Union and China, further complicate an efficient tuberculosis control. For decades, there was no new release of an antituberculous drug to efficiently fight tuberculosis. Hence, also drug development has to keep up with the development of resistance by the pathogen. The following review describes the immune response to M. tuberculosis infection and the deduction of strategies for novel vaccines. Thanks to international financial support, several new vaccine candidates are already in the pipeline and close to clinical testing phases.
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Dr. med. Timo Ulrichs
Leiter der Sektion Tuberkulose, Koch-Metschnikow-Forum, Langenbeck-Virchow-Haus
Luisenstr. 59
10117 Berlin
eMail: timo.ulrichs@bmg.bund.de
