04133nas a2200469   4500000000100000008004100001260003800042653002500080653001800105653002300123653002200146653001400168653002500182653001800207653001700225653001600242653001600258653001200274100001400286700001500300700001700315700001300332700001400345700001300359700001400372700001300386700001700399700001300416700001200429700001400441700001400455700001200469700001500481700001100496700001400507245016800521856026000689300001100949490000700960520267100967022002503638       2026                            d  c06/2026bVM Media Group sp. z o.o10aTherapeutic vaccines10aT-Lymphocytes10aImmunity, Cellular10aImmunologic Tests10aAdjuvants10aMycobacterium vaccae10aImmunotherapy10aDrug Therapy10aCombination10aBCG Vaccine10aleprosy1 aAshinze P1 aAdenekan T1 aNoze-Otote O1 aAkande E1 aOladosu D1 aEgbunu E1 aMahmoud A1 aFatoye J1 aOlowookere S1 aJegede S1 aAhmed A1 aAyodele D1 aSolomon S1 aMoody F1 aOwoyemi OP1 aUmoh J1 aAshinze M00aTherapeutic vaccines and adjunctive immunotherapeutic approaches to multidrug therapy for the management of leprosy: A multiaxial review of evidence and trajectory  uhttps://scholar.google.nl/scholar_url?url=https://journals.viamedica.pl/forum_dermatologicum/article/download/111859/89544&hl=nl&sa=X&d=17504480540371657569&ei=JCEjaoz9IJLwieoPg8Kf8Qk&scisig=ANDmEU6tJJAxnPclY6bWeANbFHou&oi=scholaralrt&hist=732gnZIAAAAJ:25  a1 - 120 v123 a<p><strong>Background:</strong></p>

<p>Leprosy, caused by Mycobacterium leprae and Mycobacterium lepromatosis, is a chronic granulomatous infection affecting the skin and peripheral nerves. Despite the marked reduction in global prevalence attributable to World Health Organization (WHO)-supported multidrug therapy (MDT), persistent transmission, immune-mediated reactional episodes, relapse in multibacillary patients, and long-term disability continue to represent significant public health challenges. Treatment outcomes are largely determined by host immune responses, underscoring the limitations of chemotherapy alone.</p>

<p><br />
Therapeutic vaccines and adjunctive immunotherapeutic approaches may augment protective cell-mediated immunity, accelerate bacterial clearance, attenuate reactional episodes, and reduce relapse risk. Systematically mapping these strategies alongside MDT is essential for identifying evidence gaps and informing future translational research.</p>

<p><strong>Methods:</strong></p>

<p>A scoping review was conducted following the Arksey and O’Malley framework, refined by Joanna Briggs Institute (JBI) recommendations, and reported in accordance with PRISMA-ScR guidelines. Systematic searches were performed in PubMed, Scopus, Web of Science, and the Cochrane Library, restricted to English-language publications from 1980 to 2025. Eligible studies included clinical trials, observational studies, and translational research evaluating therapeutic vaccines and immunotherapeutic agents as adjuncts to MDT. Thirty-five studies met inclusion criteria after independent dual-reviewer screening and full-text assessment.</p>

<p><br />
<strong>Results:</strong></p>

<p>Vaccines including Mycobacterium indicus pranii (MIP), Bacillus Calmette–Guérin (BCG), and the subunit candidate LepVax demonstrated immunological and clinical benefits, particularly in multibacillary disease, including accelerated bacterial index reduction, attenuated reactional episodes, and preliminary evidence for relapse prevention. Cytokine-based strategies, immunomodulators, and host-directed therapies contributed to immune rebalancing and nerve protection. Evidence quality was limited by heterogeneous study designs, small sample sizes, and a paucity of late-phase trials.</p>

<p><strong>Conclusions:</strong></p>

<p>Integrating immunotherapeutic strategies with MDT shows genuine promise for improving leprosy outcomes and supporting global elimination goals. Large-scale, standardized, multicenter trials with validated endpoints are required to generate evidence of sufficient quality for programmatic adoption.</p>
  a2451-151X, 2451-1501