In a paper published in the Journal of Clinical Investigation, a research team at Johns Hopkins Medicine and the Johns Hopkins Bloomberg School of Public Health reports developing a therapeutic intranasal (nose-delivered) DNA vaccine against tuberculosis (TB) that fuses two genes with the goal of directing the immune system to fight drug-tolerant bacterial “persisters” that can survive prolonged antibiotic therapy and contribute to disease relapse.

A scourge for at least the past 6,000 years, TB is estimated by the World Health Organization (WHO) to be a latent, symptom-free infection in about one-quarter of the world’s population, approximately 2 billion people. In 2024 alone, WHO reported that more than 10 million people worldwide developed active TB disease, with 1.2 million deaths recorded. This makes TB the leading cause of death from a single infectious disease.

In recent years, WHO has called for therapeutic vaccines that can be used alongside drug therapies to shorten TB treatment regimens and improve outcomes, particularly because long multidrug courses are difficult to complete, and drug-resistant TB strains continue to emerge. The vaccine described in the new Johns Hopkins study shows promise for meeting that need.