Effects of infection with atypical mycobacteria on BCG vaccination and tuberculosis.
Effects of infection with atypical mycobacteria on BCG vaccination and tuberculosis.
复制标题
非典型分枝杆菌感染对卡介苗接种和结核病的影响。
DOI：
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发表时间：
1966
期刊：
影响因子：
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通讯作者：
M. Long
中科院分区：
文献类型：
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作者：
C. Palmer;M. Long
在人群中评估卡介苗接种抗结核效果的尝试产生了惊人的不同结果。最鲜明的对比出现在英国医学研究理事会（1）和美国公共卫生署（2，3）进行的大型对照研究中。在英国的研究中，未接种疫苗的对照组的结核病发病率比接种疫苗的对照组高出4到5倍。在公共卫生服务研究中，对照组的发病率仅略高于接种疫苗组。接受英国的结果将导致这样的观点，即接种结核病疫苗是控制结核病的一个有价值的工具。接受公共卫生服务的结果自然会导致相反的结论。为了使这些和其他疫苗接种研究的结果一致，人们进行了各种尝试。一种解释是这种差异与非典型分枝杆菌感染有关。对这些感染的认识仍然有限，但在人体和实验室研究中已经做了足够的工作（4-12），以证明这些微生物的感染以不同的频率和强度诱导非特异性（交叉或异源）结核菌素反应。此外，实验室研究（1 - 3 -19）和人体研究（1-3，20）表明，非典型分枝杆菌感染可产生某些能力（不同分枝杆菌之间差异显著），以改变毒性结核病的病程。这些生物体的感染构成了一种“自然”疫苗接种，类似于卡介苗接种。本文报告了一项实验室实验的结果，该实验试图在豚鼠中重现卡介苗接种后最可能发生的情况。
Attempts to assess the antituberculous effects of BCG vaccination in human populations have produced strikingly different results. The sharpest contrast appears in the large controlled studies carried out by the British Medical Research Council (1) and by the U.S. Public Health Service (2, 3). In the British study, the tuberculosis morbidity rate among unvaccinated control subjects was between four and five times higher than in comparable vaccinated groups. In the Public Health Service studies, the rates were only slightly higher in control subjects than in vaccinated groups. Acceptance of the British results would lead to the view that vaccination against tuberculosis is a valuable tool in tuberculosis control. Acceptance of the Public Health Service results naturally leads to an opposing conclusion. Various attempts have been made to reconcile the results of these and other vaccination studies. One explanation is that the differences are related to infections with atypical mycobacteria. Knowledge of these infections is still limited, but enough has been done in both human and laboratory studies (4-12) to demonstrate that infection with these organisms induces, with differing frequency and intensity, nonspecific (cross or heterologous) tuberculin reactions. Also, laboratory studies (13-19) show, and human studies (1-3, 20) suggest that infections with atypical mycobacteria create some capacity-varying markedly for the different mycobacteria-to modify the course of virulent tuberculous disease. Infection with these organisms constitutes a kind of "natural" vaccination that resembles vaccination with BCG. The present paper is a report of results from a laboratory experiment in which an attempt was made to reproduce in guinea pigs what most likely occurs when BCG vaccination is