Tuberculosis (TB) is the major cause of death from
infectious diseases around the world, particularly in HIV infected individuals. TB
vaccine design and development have been focused on improving Bacille Calmette-Guérin (BCG) and evaluating recombinant and viral vector expressed Mycobacterium tuberculosis (Mtb)
proteins, for boosting BCG-primed immunity, but these approaches have not yet yielded significant improvements over the modest effects of BCG in protecting against
infection or disease. On March 7-8, 2016, the National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on "The Impact of Mtb Immune Evasion on Protective Immunity: Implications for TB
Vaccine Design" with the goal of defining immune mechanisms that could be targeted through novel research approaches, to inform
vaccine design and immune therapeutic interventions for prevention of TB. The workshop addressed early
infection events, the impact of Mtb evolution on the development and maintenance of an adaptive immune response, and the factors that influence protection against and progression to active disease. Scientific gaps and areas of study to revitalize and accelerate TB
vaccine design were discussed and prioritized. These included a comprehensive evaluation of innate and Mtb-specific adaptive immune responses in the lung at different stages of disease; determining the role of B cells and
antibodies (Abs) during Mtb
infection; development of better assays to measure Mtb burden following exposure,
infection, during latency and
after treatment, and approaches to improving current animal models to study Mtb immunogenicity, TB disease and transmission.