BCG Moreau Vaccine Safety Profile and NK Cells-Double Protection Against Disseminated BCG Infection in Retrospective Study of BCG Vaccination in 52 Polish Children with Severe Combined Immunodeficiency
BCG Moreau Vaccine Safety Profile and NK Cells-Double Protection Against Disseminated BCG Infection in Retrospective Study of BCG Vaccination in 52 Polish Children with Severe Combined Immunodeficiency
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DOI：
10.1007/s10875-019-00709-1
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发表时间：
2019-11-20
影响因子：
9.1
通讯作者：
Mikoluc, Bozena
中科院分区：
文献类型：
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作者：
Bernatowska, Ewa;Skomska-Pawliszak, Malgorzta;Mikoluc, Bozena
该研究的目的是估计由波兰Biomed公司生产的卡介苗莫罗活疫苗在严重联合免疫缺陷（SCID）患者中的不良反应率。将1980-2015年在华沙儿童纪念健康研究所住院的52例出生时接种卡介苗的SCID患者的资料与Beatriz E. Marciano et al.在一项回顾性研究中分析的349例其他国家接种卡介苗的SCID患者的资料进行比较（Marciano et al.）。[J] .中华过敏症杂志，2014;33(4):1134-1141。结果：与Marciano研究相比，弥散性卡介苗感染（52例SCID中有10例，19%）显著减少(3449例中有119例，34% (p = 0.0028)，接受SCID抗结核药物治疗的患者中除1例死亡外，无死亡病例。在我们的研究中，仅在T-B+NK-表型的SCID中观察到播散性卡介苗感染，且NK细胞计数明显降低（p = 0.0161）。NK细胞对局部卡介苗反应频率无影响。在CMHI研究中，造血干细胞移植（HSCT）的数量显著增加（p = 0.0001）。提供了至少两种药物的抗结核治疗。结论波兰生产的卡介苗莫罗疫苗具有良好的遗传特征，似乎比世界其他地区使用的卡介苗亚株更安全。重要的是，NK细胞似乎在保护SCID患者免受播散性卡介苗并发症方面发挥作用，而NK- SCID患者更容易出现播散性卡介苗并发症。由于患者的生存和它们对卡介苗感染的保护，造血干细胞移植和结核病治疗可能是相关的。
Objectives The aim of the study was to estimate the rate of adverse reactions to live BCG Moreau vaccine, manufactured by Biomed in Poland, in severe combined immunodeficiency (SCID) patients. Material The profiles of 52 SCID patients vaccinated at birth with BCG, hospitalized in Children's Memorial Health Institute, Warsaw (CMHI), in the years 1980-2015 were compared with those of 349 BCG-vaccinated SCID patients from other countries analyzed by Beatriz E. Marciano et al. in a retrospective study (Marciano et al. J Allergy Clin Immunol. 2014;133(4):1134-1141). Results Significantly less disseminated BCG infections (10 out of 52 SCID, 19%) occurred in comparison with Marciano study-119 out of 349, 34% (p = 0.0028), with no death in patients treated with SCID anti-TB drug, except one in lethal condition. In our study, disseminated BCG infection was observed only in SCID with T-B+NK- phenotype and significantly lower NK cell counts (p = 0.0161). NK cells do not influence on the frequency of local BCG reaction. A significantly higher number of hematopoietic stem cells transplantations (HSCT) were performed in CMHI study (p = 0.0001). Anti-TB treatment with at least two medicines was provided. Conclusion The BCG Moreau vaccine produced in Poland, with well-documented genetic characteristics, seems to be safer than other BCG substrains used in other regions of the world. Importantly, NK cells seem to play a role in protecting SCID patients against disseminated BCG complications, which NK- SCID patients are more prone to. HSCT and TB therapy could be relevant due to the patients' survival and the fact that they protect against BCG infection.