University of Oxford study provides important insights into TB correlates of protection

3 November 2022

Researchers from the University of Oxford have today reported findings from a study that investigated whether previously identified correlates of protection associated with risk of full-blown tuberculosis (TB) disease could also be associated with risk of infection from the bacteria that causes TB.

In their paper on the TB020 study, published in Nature Communications, researchers identified that certain correlates of protection – inflammation and activation of the immune system (where the body responds to invading pathogens such as viruses and harmful bacteria) – were associated with the likelihood of becoming infected with Mycobacterium tuberculosis (M.tb), the bacteria that causes TB disease.

However, their previously identified correlates of risk of TB disease were not associated with an increased risk of M.tb infection in infants who became infected with the bacteria but did not progress to active TB.

Most individuals infected with M.tb do not progress to full TB disease. Instead, infection is either eliminated or contained by the infected individual. This study improves understanding of the immune-related factors that drive infection and disease – necessary for an effective TB vaccine that is yet to be developed.

The identification of specific correlates of protection for infection could support the development of a vaccine against M.tb that would then help prevent progression to TB disease. Confirming or not whether there are common correlates of risk for both TB disease and M.tb infection is also important for using prevention of infection (PoI) studies as a substitute for PoD studies to accelerate TB research. PoI studies are quicker and more cost effective than PoD studies as numbers of infected individuals far exceed those who get TB disease

Helen McShane, Professor of Vaccinology at the Jenner Institute, Nuffield Department of Medicine, University of Oxford, said:
‘We are delighted with the findings of this immune correlate study showing immune correlates of risk of TB disease and M.tb infection are different – these findings give insight into what kind of immune response is needed in a new TB vaccine and also suggest that prevention of infection studies should not be used as a selection process for prevention of disease studies and vaccines as results may be misleading.’

The research team analysed blood samples from 43 HIV-negative South African infants aged three to six months who received BCG within seven days of birth and previously participated in a trial assessing the efficacy of the MVA85A TB vaccine.

The research was funded by TBVAC2020 and the Wellcome Trust. Helen McShane is a Wellcome Trust Investigator (grant code WT 206331/Z/17/Z).

Notes for editors

Link to the paper – https://rdcu.be/cYS4E

For further information, a copy of the paper or to request an interview with the researchers, please contact: [email protected] or call 01865 280528.

About TB
The World Health Organisation (WHO) estimates that tuberculosis caused over 1.6 million deaths in 2021. It is still the 13th leading cause of death and second leading infectious killer after COVID-19 (above HIV/AIDS).
An estimated 10.6 million cases of TB were reported in 2021, 1.2 million of them children. The WHO estimates by 2022, $13 billion will be needed annually for TB prevention, diagnosis, treatment and care to achieve the global target agreed at the UN high level-meeting on TB in 2018.
Funding in low- and middle-income countries (LMICs) that account for 98% of reported TB cases falls far short of what is needed, says the WHO. Spending in 2020 amounted to $5.3 billion, less than half (41%) of the global target.
There was an 8.7% decline in spending between 2019 and 2020 (from $5.8 billion to $ 5.3 billion), with TB funding in 2020 back to the level of 2016, adds the WHO.

About the Jenner Institute
The Jenner Institute is based within the Nuffield Department of Medicine, University of Oxford, and is headquartered at the Old Road Campus Research Building, in Headington, Oxford. The Jenner Institute also supports senior vaccine scientists, known as Jenner Investigators, within many other departments across the University of Oxford, as well as externally within The Pirbright Institute and the Animal and Plant Health Agency.
The Jenner Institute brings together investigators who are designing and developing numerous vaccines to generate an exceptional breadth of scientific know-how and critical mass, whilst still allowing the individual investigators to remain independent and accountable to their funders and stakeholders.
The Jenner Institute is supported by the Jenner Vaccine Foundation, a UK registered charity and is advised by the Jenner Institute Scientific Advisory Board.

About the University of Oxford
Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the seventh year running, and number 2 in the QS World Rankings 2022. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.
Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.
Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 200 new companies since 1988. Over a third of these companies have been created in the past three years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing £15.7 billion to the UK economy in 2018/19, and supports more than 28,000 full time jobs.