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Durability of systemic and lung immune correlates of BCG-induced protection against M. tuberculosis infection

Award Number: R01AI150850
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/11/2020
PERIOD OF PERFORMANCE END DATE: 07/31/2026

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Durability of systemic and lung immune correlates of BCG-induced protection against M. tuberculosis infection - Project summary Mycobacterium tuberculosis (M.tb) causes more deaths worldwide than any other infectious agent and is increasingly characterized by antimicrobial resistance. An effective vaccination strategy to prevent establishment of M.tb infection and progression to tuberculosis (TB) disease is a priority to achieve rapid control of the global TB epidemic, but development and clinical testing of new vaccines is hampered by the lack of immune correlates of protection. Revaccination of adolescents with the only licenced vaccine against TB, Bacille Calmette-Guerin (BCG), partially protected against established M.tb infection, providing the first efficacy signal for a novel TB vaccination strategy in a high-risk population. There is a one-time opportunity to leverage this existing cohort, as well as newly enrolled participants in a larger confirmatory phase 2b clinical trial, to identify and test the durability of immune correlates of protection against established M.tb infection in the lung, which could harbour critically different immune responses compared to peripheral blood. Blood and bronchoalveaolar lavage specimens will be collected to identify and determine longevity of vaccine- induced systemic and pulmonary immune responses that correlate with protection against sustained M.tb infection. The durability of vaccine-induced protection against infection ~6 years after vaccination will also be explored. Novel and robust technologies, such as polychromatic flow cytometry, mass cytometry and systems serology will be applied to study adaptive and innate immune responses in participants enrolled in two BCG efficacy trials at 6 months and ~6 years after vaccination as well as 1 month and 4-5 years after primary M.tb infection. The overarching hypothesis is that BCG vaccination induced multiple arms of the immune system and that a combination of Th1/Th17 and IgA responses is associated with lower risk of established M.tb infection. This approach will: 1) Identify and assess durability of BCG-mediated systemic and pulmonary immune responses in M.tb-uninfected individuals; 2) Define systemic and pulmonary immune correlates of post- M.tb exposure protection against established M.tb infection in participants experiencing transient (protected) or sustained (unprotected) M.tb infection. Identification of vaccine-induced immune responses important for protection against established M.tb infection would enhance our understanding of early containment of M.tb and could inform immune correlates of protection against TB disease. By extending the follow-up of the first BCG revaccination trial and comparing rates of M.tb infection in participants from the BCG and placebo arms, we will also 3) Measure the durability of vaccine-mediated prevention of sustained M.tb infection for at least 6 years post-vaccination, which, if significant, would provide impetus to conduct larger trials testing for efficacy to prevent TB disease in endemic populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $587,434 )
2025	2025	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	Allergy and Infectious Diseases Research	000	5	9/4/2025	NON-COMPETING CONTINUATION	$587,434
														Subtotal = $587,434

Issue Date FY: 2024 ( Subtotal = $593,748 )
2024	2024	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	Allergy and Infectious Diseases Research	000	4	8/16/2024	NON-COMPETING CONTINUATION	$593,748
														Subtotal = $593,748

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	Allergy and Infectious Diseases Research	000	3	8/21/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $594,124 )
2022	2022	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH				ZAF	Allergy and Infectious Diseases Research	000	3	8/4/2022	NON-COMPETING CONTINUATION	$594,124
														Subtotal = $594,124

Issue Date FY: 2021 ( Subtotal = $536,131 )
2021	2021	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH				ZAF	Allergy and Infectious Diseases Research	000	2	8/3/2021	NON-COMPETING CONTINUATION	$536,131
														Subtotal = $536,131

Issue Date FY: 2020 ( Subtotal = $539,429 )
2020	2020	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH		007700		ZAF	Allergy and Infectious Diseases Research	000	1	8/10/2020	NEW	$539,429
														Subtotal = $539,429

Grand Total All Awards = $2,850,866

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Durability of systemic and lung immune correlates of BCG-induced protection against M. tuberculosis infection

Award Number: R01AI150850

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/11/2020

PERIOD OF PERFORMANCE END DATE: 07/31/2026

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