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Développement d’un vaccin thérapeutique multi-antigénique contre la tuberculose et étude de l’influence des antibiotiques antituberculeux sur son immunogénicité

Abstract : Tuberculosis (TB), a lung disease caused by Mycobacterium tuberculosis (Mtb), remains the leading cause of death worldwide from an infectious disease. TB is responsible for an estimated 1,7 million of deaths and 10,4 million new cases annually. The emergence and spreading of multidrug resistance (MDR) Mtb strains represent a major global threat and reflect limitation of current treatments. Patients with MDR-TB are currently treated with multiple drug regimens, often toxic, given for long durations, with a limited efficacy. Therefore, developing novel TB therapies is urgently needed. Immunotherapy aiming at triggering specific immune response against Mtb represents an attractive approach to shorten the duration and increase the efficacy of current MDR-TB treatment. The first aim of this PhD project was to characterize a novel therapeutic vaccine, based on the Modified Vaccinia virus Ankara (MVA), MVATG18598, expressing ten antigens representative of the three phases of Mtb infection. Using different strains of mouse, we showed that MVATG18598 vaccination is able to trigger Mtb antigens-specific humoral and cellular responses. Both CD4 and CD8 T cells display the capacity to produce multiple Th1-cytokines together with cytolytic activity. In post-exposure mouse models, MVATG18598 combined with an antibiotic regimen decreases significantly the bacterial burden in lungs of infected mice as well as the disease relapse rate after treatment completion. The second aim of this project was to analyze the impact of TB antibiotics on the immunogenicity of the MVATG18598 vaccine. We showed that first-line antibiotic regimen, mostly isoniazid, decreases antigen-specific Th1 immune response triggered by MVATG18598 vaccination in mice. Moreover, we demonstrated that Mtb-specific antibody response induced by the vaccine candidate is modified and shifted towards an increase of IgG1/IgG2a ratio in presence of drugs. Altogether, these results illustrate that immunotherapeutic vaccine such as MVATG18598 has the capacity to contribute to the control of TB by improving efficiency of anti-TB drugs treatment. In addition, our results indicate that antibiotics are able to modulate vaccine-induced immune response, a feature to consider for the future development of immunotherapies
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Charles-Antoine Coupet. Développement d’un vaccin thérapeutique multi-antigénique contre la tuberculose et étude de l’influence des antibiotiques antituberculeux sur son immunogénicité. Immunologie. Université de Lyon, 2018. Français. ⟨NNT : 2018LYSE1297⟩. ⟨tel-02336452⟩

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