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Tuberculosis (TB) is the leading cause of death by an infectious agent worldwide. The Bacillus Calmette-Guérin (BCG) is the only licensed vaccine against TB and the most widely used vaccine in history. Since 1921, billions of people have been vaccinated with BCG, resulting in a remarkable decline in infant mortality. However, although BCG's efficacy to prevent TB meningitis and disseminated disease in children is well established, its efficacy to prevent infection, disease or reactivation in adolescents and adults is variable. Therefore, novel TB vaccines are urgently needed. Recent clinical trials have shown promising results, offering hope for the introduction of a new generation of vaccines to replace or boost BCG.
The book is structured into five sections, each providing sequential relevance to understanding the current landscape and future developments in TB vaccines. Section 1 introduces TB and the causative agent, Mycobacterium tuberculosis. Section 2 presents historical perspectives on BCG and TB vaccine candidates. Section 3 focuses on pre-clinical vaccines against TB. Section 4 examines vaccines against TB currently in clinical trials. Finally, section 5 discusses public health and societal challenges associated with the development of TB vaccines.
This book is an essential tool for students, clinicians, and scientists working in the fields of mycobacteriology, vaccine immunology, vaccine development, and TB vaccines, and it is anticipated to stimulate future research in TB vaccine development.
Paulo J. G. Bettencourt holds a BSc in Biotechnology from ISHT in Lisbon, Portugal, a Master's degree in Immunology and Immunogenetics from the University of Manchester, UK, and a PhD in Pharmacy from the University of Lisbon, Portugal. He completed seven years of post-doctoral research in Vaccinology at the renowned Jenner Institute at Oxford University, UK, where the ChAdOx1-S/nCoV-19 vaccine against COVID-19, and the R21 vaccine against malaria were developed.
Currently, he is an Assistant Professor, Principal Investigator, Director of the Research and Teaching Laboratories, and Coordinator of the MSc in Immunology and Vaccinology, at the new Faculty of Medicine at the Universidade Católica Portuguesa (UCP), which he co-founded. Additionally, he was appointed as the coordinator of the platform CatólicaMed at the Center for Interdisciplinary Research in Health, at UCP.
His postdoctoral research has led to the identification of three new candidate antigens for TB vaccines, currently in preclinical development. Prof. Bettencourt's current research is focused on three main areas: 1) the interaction between pathogens and the immune system focusing on the discovery of antigens using immunopeptidomics, 2) the translation of fundamental immunology into the design of mRNA vaccines against TB, malaria, and Staphylococcus aureus infections, and 3) the impact of Vaccination in Global Health.
Through the combination of immunology and vaccinology, Prof. Bettencourt aims to contribute to the development of innovative medical interventions with significant importance and impact for humanity.
PART I: Introduction to tuberculosis.- 1. Introduction to tuberculosis and mycobacteriology.- PART II: Historical perspectives on BCG and tuberculosis vaccine candidates.- 2. 100 years of BCG against tuberculosis and other diseases.- 3. TB or not TB - The parallel lives of BCG.- 4. Induction of trained immunity and non-specific protective effects against heterologous diseases by BCG vaccination.- PART III: Pre-clinical vaccines against tuberculosis.- 5. New vaccine strategies to improve, boost, or replace BCG.- 6. Pre-clinical landscape of TB vaccines: challenges and innovations.- 7. Pre-clinical studies and animal models.- 8. Pre-clinical tuberculosis vaccine development: understanding immune response to infection to inform next generation vaccine development.- PART IV: Vaccines against tuberculosis in clinical trials.- 9. Novel prophylactic TB vaccines in clinical trials.- 10. Live attenuated vaccines in clinical trials.- 11. New vaccine strategies based on viral vectors and mRNA.- 12. Systems immunology and omics data from developing countries are needed to inform vaccine development.- PART V: Public Health and Societal challenges for the development of TB vaccines.- 13. Public health strategies and prevention of tuberculosis.- 14. Technological advances applied to TB vaccine development: how can AI contribute to the development of new TB vaccines?.- 15. From cutting edge science to innovative finance: the road to TB vaccine implementation.
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