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Oral bacterial vaccines for the prevention of acute exacerbations in chronic obstructive pulmonary disease and chronic bronchitis.

Oral vaccines using killed bacterial extracts have been used to prevent acute exacerbations of chronic obstructive pulmonary disease (COPD); however, they are not recommended by current clinical guidelines. Two systematic reviews have been published on the efficacy of oral vaccines. The first, on the effects of an oral whole-cell nontypeable Haemophilus influenzae vaccine (NTHi) found a significant decrease in the incidence of acute episodes of chronic bronchitis (Poisson rate ratio 0.666; 95% confidence interval (CI) 0.500, 0.887; P = 0.005), and a 58% reduction in the prescription of antibiotics 3 months after vaccination. The second review evaluated studies that used multicomponent vaccines. It found that the duration of exacerbations was significantly shorter in the treatment group (weighted mean difference -2.7 days, 95% CI -3.5 to -1.8). These reviews suggest that oral vaccines reduce the number, severity, duration, or both, of acute exacerbations. However, many of the primary trials on which they are based are small and methodologically flawed. Further trials are needed before the use of oral vaccines could be considered as part of the routine clinical management of patients with COPD or chronic bronchitis.

Administration, Oral↗

Antigenicity testing of inactivated oral enteric bacterial vaccines for human use.

This study deals with the laboratory testing of the antigenicity of inactivated oral enteric bacterial vaccines for human use, viz. typhoid, dysentery, Escherichia coli and cholera vaccines. For the assays the following methods are applied : 1) various types of active mouse protection tests 2) serum and coproantibody determinations in immunized persons and experimental animals, 3) protective ability of the immune sera in mice and embryonated eggs, 4) hemolytic and bacteriolytic plaque assays. It is pointed out that the most important question: how far the results of these tests are in agreement with the degree of efficacy of vaccines in man, requires to be clarified.

Administration, Oral↗

Progress toward the development of a bacterial vaccine vector that induces high-titer long-lived broadly neutralizing antibodies against HIV-1.

Conformationally constrained HIV-1 Env and gp120 immunogens induce broadly cross-reactive neutralizing antibodies. Thus, it is now feasible to rationally design an HIV-1 vaccine that affords protection through humoral mechanisms. This paper reviews our progress toward the development of an oral bacterial vaccine vector that is capable of delivering an HIV-1 DNA vaccine to host lymphoid tissues and inducing broadly neutralizing antibodies to HIV-1 in the mucosal and systemic immune compartments.

AIDS Vaccines↗

The effect of a bacterial vaccine on tumors and the immune response of ICR/Ha mice.

This study examined the effect of mixed bacterial vaccine (MBV), a biological response modifier prepared from Streptococcus pyogenes and Serratia marcescens, on the immune system of mice and on the regression of a transplantable mouse tumor sarcoma 37. The study examined MBV's biological properties and analyzed its chemical composition. The chemical composition varied with the growth media. A typical centrifuged, dialyzed supernate of the serum-containing preparation was found to consist mainly of protein and minimal amounts of carbohydrate and endotoxin, while MBV made with synthetic medium contained similar amounts of all three. MBV was nontoxic for mice, which gained weight following the injection of 0.5-1.0 ml of MBV. MBV caused regression of 20-100% of well-established mouse tumors without appreciable toxicity. MBV also had a striking effect on the immune response of mice to sheep red blood cells. When administered simultaneously with antigen injection, MBV increased the number of antibody-secreting splenocytes measured by the plaque-forming assay threefold. Serum antibody levels also increased two- to threefold. MBV did not enhance the immune response to pneumococcal polysaccharide type III, a B-cell-dependent response. However, the in vivo administration of MBV increased the in vitro response to MBV and the B-cell mitogen lipopolysaccharide. MBV compares favorably with other biological response modifiers because of its enhancing effect on the immune response and its oncolytic properties at nontoxic levels.

Animals↗

[Treatment of adult type atopic dermatitis (AD) with bacterial vaccine prepared from individual cases (II)--The mechanism].

Sixty eight cases with severe adult type AD treated by bacterial vaccine were classified into 2 subgroups, effective and ineffective cases. And the differences of these 2 subgroups were examined by various laboratory data. In effective groups, specific IgG antibody level against bacteria increased to correlate to the clinical course. In contrast, ineffective groups were not changed the antibody level. There were no significant differences between these 2 subgroups concerning results of specific IgE antibody level against bacteria. Decrease of CD4/CD8 ratio was more prominent in effective groups than ineffective groups after treated for 6 months. It is known that bacteria and bacterial products (peptidoglycan and endotoxin etc) cause release of histamine. Our results support that the elevation of specific IgG antibody against bacteria and enhanced cell mediated immunity are decreased the numbers of bacteria on the skin surface and improved irritable skin. These effects may be inhibit histamine release induced by bacteria, so therefore we suggest that general skin condition and pruritus with AD will be improved by the treatment.

Adult↗

The effects of laboratory animal diets on the potency tests of bacterial vaccines.

Comparative studies of the responses elicited by mice fed on PCD and FFG diets to a number of bacterial vaccines have shown a significant reduction in the immune response to tetanus toxoid but not to Clostridium septicum toxoid and increased resistance to challenge with E. coli and syngeneic tumour cells but not to Pasteurella multocida. These differences cannot readily be explained in terms of differences between the identifiable constituents of the diets and illustrte the dangers of vaccine potency tests that require an absolute level of response to the material under test.

Animal Nutritional Physiological Phenomena↗

Recent advances with recombinant bacterial vaccine vectors.

Bacille Calmette-Guerin (BCG), Listeria monocytogenes, Salmonellae and Shigellae have shown promise as vaccine vectors in experimental animal models. Although disappointing results in humans and non-human primates stalled the development of this vaccination strategy, interest in this approach was reinvigorated recently by the development of bacterial DNA-vaccine-vectors. The purpose of this review is to highlight the strengths and weaknesses of bacterial vaccine vectors, and to discuss the future prospects of these vaccine delivery systems.

Animals↗

[Results of 7 years of prophylactic immunotherapy using a bacterial vaccine in chronic bronchopneumopathies].

Within the framework of a clinical study intended to evaluate the prophylactic efficacy of polymicrobial vaccines, 90 patients with chronic bronchopulmonary disease were treated for four successive years with an oral bacterial vaccine. The following parameters were considered: number of episodes of acute bronchitis per years, hospitalizations for respiratory events, number of housebound days due to flare-ups, number of days on antibiotics. Results were favorable: in the 4th year of treatment, acute episodes were reduced by 46%, hospitalizations by 50%, housebound days by 46%, and days on antibiotics by 52%. These results appear to be closely related to the careful selection of patients (exclusion of subjects in initial or advanced stages of disease) and to scrupulous compliance with treatment protocol. In fact, out of the 162 subjects entering the trial, only 90 followed it regularly.

Adult↗

[Modern bacterial vaccines].

A well founded vaccination strategy is of crucial importance for controlling communicable diseases. The WHO Enlarged Vaccination Programme of 1976 provides to protect by vaccination all children in the world against six infection diseases - diphtheria, pertussis, tetanus, measles, poliomyelitis, and tuberculosis, a sure immunization prophylaxis being possible against them. The perspectives of further development of some classical vaccines as against cholera, typhoid fever, and pertussis are reviewed. Some recent bacterial vaccines are discussed being of special significance for controlling nosocomial infections and for protecting patients in intensive therapy and/or persons with lowered immunological defence. New ways for production of vaccine matters are shown such as capsule polysaccharides, membrane proteins, subcellular fractions, and vaccines with synthetic carrier molecules. Fundamental problems concerning the initiation of vaccination and the demands for an enlarged proof of innocence of vaccines are discussed.

Aged↗

Bacterial vaccines and serotype replacement: lessons from Haemophilus influenzae and prospects for Streptococcus pneumoniae.

Conjugate vaccines have reduced the incidence of invasive disease caused by Haemophilus influenzae, type b (Hib), in industrialized countries and may be highly effective against Streptococcus pneumoniae. However, the serotype specificity of these vaccines has led to concern that their use may increase carriage of and disease from serotypes not included in the vaccine. Replacement has not occurred with the use of Hib vaccines but has occurred in trials of pneumococcal vaccines. Mathematical models can be used to elucidate these contrasting outcomes, predict the conditions under which serotype replacement is likely, interpret the results of conjugate vaccine trials, design trials that will better detect serotype replacement (if it occurs), and suggest factors to consider in choosing the serotype composition of vaccines.

Bacterial Vaccines↗

[Importance of bacterial vaccines].

The vaccines presently developed in laboratories are more numerous than the ones in current use. This acceleration of research efforts was made possible by a genuine biotechnological revolution which opened new avenues for vaccine preparation, with techniques such as the selection of relevant antigens and the use of subunit vaccines. Genetic engineering plays an increasing part in the development and production of both live and inactivated vaccines.

Bacterial Vaccines↗

Vaccination against Bordetella bronchiseptica infection in dogs using a heat-killed bacterial vaccine.

A group of eight-week-old dogs was inoculated with a heat-killed suspension of Bordetella bronchiseptica by the intramuscular route on two occasions at an interval of two weeks. All vaccinated animals developed high circulating agglutinin titres by two weeks after the second inoculation at which time the vaccinated dogs and a comparable group of unvaccinated animals were challenged by exposure to an aerosol of live B bronchiseptica. Both vaccinated and unvaccinated dogs subsequently developed clinical respiratory disease characterised by persistent coughing but the onset of disease in vaccinated animals was delayed by up to five days when compared with the controls. B bronchiseptica was isolated from the nasal cavity, tracheobronchial tree and lung parenchyma of vaccinated and control dogs.

Animals↗

Effect of the mixed bacterial vaccine on the immune response of patients with non-small cell lung cancer and refractory malignancies.

Since 1984, 13 patients were entered into our study and 12 patients have completed one or more cycles of treatment with mixed bacterial vaccine (MBV), a natural biologic response modifier derived from Streptococcus pyogenes and Serratia marcescens. Eight patients with refractory malignancy were treated with MBV only (0.1 ml intravenously [IV]) twice weekly for 3-16 weeks (colorectal cancer, pancreatic cancer, chronic lymphatic leukemia, hepatoma [two patients], sarcoma [three patients]). Four patients with advanced non-small cell lung cancer were treated with MBV in combination with low-dose cyclophosphamide, day 1; cisplatin, day 15; and MBV, 0.1 ml IV, days 5, 7, and 9. Two patients in this study received cyclophosphamide and cisplatin alone. The cycle was repeated every 28 days. Plasma interferon levels, interleukin-2 production by peripheral lymphocytes, and lymphocyte subpopulations were monitored. Interferon levels and interleukin-2 production showed increased or sustained values in general. In some patients, B-cells and helper T-cell populations increased, whereas T-suppressor cell numbers declined. With one exception, side effects were mild and consisted of fever greater than 37.8 degrees C (nine of 13), chills (11 of 13), increased respiratory rate (nine of 13), minor changes in blood pressure (seven of 13), and nausea (three of 13). One patient with non-small cell lung cancer had a partial response. Two patients with non-small cell lung cancer and one patient with refractory malignancy had stable disease and performance status at the end of 8 weeks of treatment; one patient with refractory malignancy was stable at the end of 4 weeks of treatment. In this pilot study, cancer patients treated with MBV showed objective evidence of immune stimulation with acceptable toxicity.

Adult↗

[Combination of oral bacterial vaccines and antibiotics in acute recurrent respiratory infections].

The authors treated 34 patients with acute bronchopulmonary disease or flare-ups of chronic ones with equal doses of ambroxol and ceftriaxone considering the homogeneity of the morbid processes. Patients were divided into two groups of 17 subjects each: group A was given a polyvalent oral bacterial vaccine, group B a placebo. Relevant differences were found between the experimental and control groups concerning cough (score: A = 108, B = 119), duration of expectoration (A = 5.3 days, B = 6.4 days), duration of antibiotic therapy (A = 8.0 days, B = 8.8 days), and length of hospitalization (A = 10.9 days, B = 12.0 days). Differences were slight as far as duration of fever, characteristics of cough and objective findings on the chest were concerned.

Acute Disease↗

Inactivated whole-cell bacterial vaccines: current status and novel strategies.

Inactivated bacterial whole-cell vaccines have been the most widely studied prophylactic treatment for infectious diseases. They offer an economical, and potentially safe, effective means of preventing disease. The disadvantages of these vaccines have been that parenteral administration, while effective in some instances, may have caused adverse reactions in vaccinees, while oral administration often required high doses and resulted in short-term immunity. More recent studies describing new approaches for improving antigenicity of inactivated whole-cell vaccines and the enhancement of immune responses to oral immunization offer great hope for improving the efficacy of these agents. Promising whole cell vaccines include those against Vibrio cholerae, enterotoxigenic Escherichia coli, and more recently Campylobacter jejuni.

Animals↗