100 años después de la BCG, vacunas vivas atenuadas frente a la tuberculosis
Palabras clave:
bacillus Calmette-Guérin, BCG, Bacille de Koch, M. tuberculosis, vacunas atenuadas, vacunas experimentales
Resumen
Durante más de un siglo, se ha utilizado la vacuna BCG, derivada de una cepa atenuada de Mycobacterium bovis conocida como bacilo de Calmette-Guérin, para prevenir la tuberculosis. A pesar de su uso extendido, la eficacia de la vacuna BCG es variable, y su protección es transitoria. El objetivo corresponde a recopilar información sobre la viabilidad y eficacia de nuevas vacunas vivas atenuadas como alternativas a la vacuna BCG en la prevención de la tuberculosis. Se llevó a cabo una revisión bibliográfica de alcance descriptivo, utilizando artículos especializados en temas médicos, de enfermería y epidemiología de los últimos dos años (2022-2023), la búsqueda se realizó de manera autónoma en diversas bases de datos. En los ensayos clínicos y estudios preclínicos, diversas vacunas vivas atenuadas, inactivadas y de subunidades/adyuvantes han mostrado potencial para mejorar la inmunogenicidad y la protección contra la tuberculosis. Vacunas como MTBVAC y RUTI están en diferentes fases de desarrollo clínico, mientras que otras, como M72/AS01E y H56, están en fases avanzadas de prueba. Se concluye que, la tuberculosis incluye enfoques innovadores como vacunas subunitarias, recombinantes y de células enteras, con avances en el uso de adyuvantes y vectores virales para mejorar la respuesta inmune. A pesar del progreso significativo, es crucial desarrollar vacunas más eficaces para adultos y optimizar combinaciones vacunales, abordando la variabilidad genética de las cepas y diferencias inmunológicas entre poblaciones.
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Campins Martí, M. y Moraga Llop, F. A. (2020). Vacunas 2020. Undergraf. S. L. https://vacunas.org/wp-content/uploads/2024/02/Vacunas_2020_compressed.pdf
Cho, T., Khatchadourian, C., Nguyen, H., Dara, Y., Jung, S. y Venketaraman V. (2021). A review of the BCG vaccine and other approaches toward tuberculosis eradication. Human Vaccines and Immunotherapeutics, 17(8), 2454-2470. https://doi.org/10.1080/21645515.2021.1885280
Chugh, S., Bahal, R. K., Dhiman, R. y Singh, R. (2024). Antigen identification strategies and preclinical evaluation models for advancing tuberculosis vaccine development. NPJ Vaccines, 9(1), 57. https://doi.org/10.1038/s41541-024-00834-y
Dhamnetiya, D., Patel, P., Jha, R. P., Shri, N., Singh, M. y Bhattacharyya, K. (2021). Trends in incidence and mortality of tuberculosis in India over past three decades: a joinpoint and age–period–cohort analysis. BMC Pulmonary Medicine, (21), 1-14. https://link.springer.com/content/pdf/10.1186/s12890-021-01740-y.pdf
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Lin, K., Cao, H., Luan, N., Wang, Y., Hu, J., y Liu, C. (2023). Comparison of the Immune Effects of an mRNA Vaccine and a Subunit Vaccine against Herpes Zoster Administered by Different Injection Methods. Vaccines (Basel), 11(5), 1003. https://doi.org/10.3390/vaccines11051003
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Organización Panamericana de la Salud (2020). Tuberculosis en las Américas. Informe Regional 2020. https://iris.paho.org/handle/10665.2/55047
Organización Panamericana de la Salud (2022). Tuberculosis https://www.paho.org/es/temas/tuberculosis
Organización Panamericana de Salud (2021). Tuberculosis en las Américas. https://www.paho.org/es/documentos/tuberculosis-americas-informe-regional-2021
Martin, C., Aguilo, N. y Gonzalo-Asensio J. (2018). Vaccination against tuberculosis. Enferm Infecc Microbiol Clin (Engl Ed), 36(10), 648-656. https://doi.org/10.1016/j.eimc.2018.02.006
Martín, C., Marinova, D., Aguiló, N. y Gonzalo-Asensio, J. (2021). MTBVAC, a live TB vaccine poised to initiate efficacy trials 100 years after BCG. Vaccine, 39(50), 7277-7285. https://doi.org/10.1016/j.vaccine.2021.06.049
Meintjes, G., Brust, J. C. M., Nuttall, J. y Maartens, G. (2019). Management of active tuberculosis in adults with HIV. The lancet HIV, 6(7), 463-474. https://pubmed.ncbi.nlm.nih.gov/31272663/
Ministerio de Salud Pública de Ecuador (2018). Boletín Anual Tuberculosis https://www.salud.gob.ec/wp-content/uploads/2019/03/informe_anual_TB_2018UV.pdf
Morales, P., y Balcells, M.E. (2019). The importance of the BCG vaccine in the prevention of childhood tuberculosis. Revista Chilena de Pediatría. Sociedad Chilena de Pediatría, 90(6), 579-580. https://doi.org/10.32641/rchped.v90i6.1379
Montoya-Rosales, A. y Salazar-Cepeda, C.P. (2024). Tuberculosis extrapulmonar: más allá de un pulmón. Revista Ciencia UANL, 27(123), 37-43. https://www.researchgate.net/publication/377354113_Tuberculosis_extrapulmonar_mas_alla_de_un_pulmon
Moradi, M., Vahedi, F., Abbassioun, A., Ramezanpour, A., Sholeh, M., Taheri, M., Dargahi, Z., Ghanavati, R., Khatami, S.H. y Movahedpour, A. (2023). Liposomal delivery system/adjuvant for tuberculosis vaccine. Immunity, inflammation and disease, 11, 1-12. https://doi.org/10.1002/iid3.867
Mustafa, A. S. (2021). Adjuvants and Antigen-Delivery Systems for Subunit Vaccines against Tuberculosis. Vaccines (Basel), 9(9), 972. https://doi.org/10.3390/vaccines9090972
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Publicado
2024-10-15
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BravoM., & Echeverría ValenciaG. (2024). 100 años después de la BCG, vacunas vivas atenuadas frente a la tuberculosis. Opuntia Brava, 16(4), 214-236. Recuperado a partir de https://opuntiabrava.ult.edu.cu/index.php/opuntiabrava/article/view/2197
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