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At least 19 recordsLinked to original sources
PubMed1984

Research on BCG vaccination.

BCG vaccination against tuberculosis has been used for many years in practically all national tuberculosis programmes. It is often the mainstay of the programme as regards young children, in whom case-finding and treatment remain deficient, especially regarding the serious meningeal and miliary forms of tuberculosis. Following contradictory reports on the effectiveness of BCG vaccination, a large-scale controlled trial was carried out in south India, under the sponsorship of WHO. The early results of this trial showed that BCG vaccination provided no protection whatsoever against bacillary disease in adults. To examine this unexpected finding WHO convened a Scientific Group, which considered that the reported results per se are valid but might not apply in general. Since the effectiveness of a potentially very useful and generally applied control measure appeared seriously challenged, a Study Group was convened by WHO. The Group considered that under the circumstances BCG vaccination, especially of young children, should be continued, but that the effectiveness of BCG vaccination should be evaluated forthwith. A comprehensive programme has been formulated accordingly. The primary objective of the programme is to evaluate in an expedient manner the effectiveness of BCG vaccination in children. A number of problems inherent to the special situation had to be circumvented. In the case of tuberculosis, community trials of the classical type have to be prolonged and are extremely costly. Moreover, since BCG vaccination has been used widely, it is virtually impossible to find a suitable trial area; many countries are reluctant to conduct such trials for ethical reasons because they require an unvaccinated group. Retrospective studies, although providing no conclusive scientific evidence when carried out in isolation, may give useful information if organized in a comprehensive evaluation programme. Another approach proposed is based on the active follow-up of child contacts of newly detected cases of tuberculosis. This provides information on the magnitude of the tuberculosis problem in children as well as a powerful retrospective evaluation of the protective effect of vaccination; in the case that the results are inconclusive a prospective approach on the same principle would be ethically justified. The study population is only a small fraction of that required in a community trial, and the follow-up of each individual is reduced to a few months. In addition to providing information on the effectiveness of BCG vaccination, the field studies, supported by other research, may clarify the variations in protection observed.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2003

[Sternal osteomyelitis and scrofuloderma due to BCG vaccination].

BCG vaccine has been used for nearly 100 years in the prevention of tuberculosis. The case of a 13 month-old girl vaccinated as a newborn with BCG is described as presenting a sternal mass with associated periostic erosion. The mass was resected, and histopathological examination revealed a chronic inflammatory reaction with caseous granulomas, and extension to bone and skin. PCR amplifications using specific primers for Mycobacterium tuberculosis on paraffin-embedded tissue were negative. BCG vaccination at birth, the histological appearance and the absence of M. tuberculosis DNA in the resected tissue indicated that osteomyelitis and scrofuloderma were a consequence of BCG. Osteomyelitis is a rarely occurring adverse effect of BCG vaccination, more commonly seen in immunosuppressed patients. In the patient described above, no symptoms of immunodeficiency were seen, however.

BCG Vaccine↗
PubMed1992

Occurrence of suppurative lymphadenitis after a change of BCG vaccine.

BCG vaccines are the oldest vaccines in use today, but the protective effect of the vaccination is still controversial. The risk of contracting tuberculosis is low compared with the possible complications after this vaccination. In Austria the formerly used BCG vaccine was not available in the required amount and another vaccine was released by the drug authorities. This product, with a more virulent strain, was used between August and December 1990, and this increased the incidence of complications. Eighty four of 1950 vaccinated newborn babies developed severe suppurative lymphadenitis three to 28 weeks after the vaccination, and surgical treatment was found to be necessary. Isoniazid treatment did not prove to be successful when the lymph node exceeded a certain size. Culture was successful in 46% up to week 20; after 20 weeks no culture became positive. All cultured bacteria were isoniazid sensitive. The question of general vaccination is raised and several points were considered before we came to the conclusion that except for high risk groups a general vaccination programme for neonates is not justified in Western countries.

Austria↗
PubMed1999

Tuberculosis II: the failure of the BCG vaccine.

BCG (bacille Calmette-Guerin) is an attenuated pathogen characterized by its capacity to induce cellular and humoral immune responses primarily against a nonpeptidic antigen, lipoarabinomannan. Immune responses against this substance contribute to the immunoprotection of the patient if the production of IL-2 and INF-gamma is not impaired. The most adequate production of INF-gamma and IL-2 is obtained by immunoreactivity against proteinic antigens. The formation of IgG-type antibodies and of cellular immunity against mycobacterial peptidic and proteinic antigens is an additional immunological response essential for a good protection. This is achieved by the BCG vaccine in only a small proportion of the vaccinees. A vaccine adjuvant that also finds application as an immunotherapeutic agent is composed of proteinic antigens such as sonicates of Mycobacterium vaccae and antigen 60 of Mycobacterium bovis. These enhance the beneficial Th1-pole of the immune response. In addition, A60 induces the formation of antibodies against species-specific proteinic antigens. Despite the questioning of its innocuousness and efficacy, the BCG vaccine was imposed worldwide in 1950 by medical and political organizations that showed no concern for these questions. The contemporary structures of research administration in this area make it unlikely that the efficacious means recently developed to complement the action of the vaccine and of chemotherapies to face the surge of tuberculosis (TB) will be readily adopted.

BCG Vaccine↗
PubMed1992

Skin test reactivity to atypical mycobacteria among healthy Finnish preschool children vaccinated with BCG vaccine at birth.

Skin test reactivity to three mycobacterial sensitins (M. avium, M. fortuitum and M. scrofulaceum) was studied in 353 healthy children vaccinated with the BCG vaccine at birth. A significant waning of reactivity to all of the three sensitins was found to occur with increasing age. Revaccination against measles, parotitis and rubella had been given to 31 (9%) of the children, all aged > 5.5 years. They had significantly larger reactions sizes, which was contrary to what was expected. Children with atopic dermatitis (n = 19) had significantly smaller reaction sizes to the M. fortuitum sensitin. Neither respiratory viral infections during the preceding six months nor contact with pets or farm animals had any influence on reaction sizes. The variation of sensitin reactions was large in preschool children vaccinated with the BCG vaccine at birth. The diagnostic value of sensitin reactions in preschool children needs to be elaborated in clinical studies in children with clinically demonstrable mycobacteriosis.

Animals↗
PubMed1995

Efficacy and safety of live recombinant BCG vaccines.

BCG has a long history of safe use in humans and is one of the best adjuvants known. The use of newer production methods may further reduce the risk of adverse side-effects. Early results with experimental animals have shown BCG to be an effective live recombinant delivery vehicle for several foreign vaccine antigens. Additional refinements to the safety and efficacy of the recombinant BCG vaccine vehicle are under development.

Animals↗
PubMed1982

Mycobacterial antibodies after tuberculin testing, BCG- vaccination, BCG-immunotherapy and against cross-reacting antigens in a solid-phase radioimmunoassay.

A solid-phase radioimmunoassay (SPRIA) was used to investigate several factors influencing false positive and negative results in serodiagnostic test for tuberculosis, Unheated cytoplasmic fractions of mycobacteria, and other microorganisms were bound to polystyrol and antibody binding of sera from tuberculous, non tuberculous hospitalized patients and healthy adults was tested by the SPRIA-method. The level of antibody concentration in the SPRIA reflects roughly cross-reactivity between the antigens. Similar antibody binding occurred with M. tuberculosis, M. bovis, M. ulcerans and several "atyical" mycobacteria as test antigens, while other mycobacterial species and one of two tested tuberculin preparation (PPD) showed less antibody binding capacity. Significant cross-reactivity of fourty to sixty per cent was found between M. tuberculosis and N. asteroides but no cross-reaction was observed with C. parvum, S. typhi, S. paratyphi, C. Albicans or Aspergillus niger. Heating of mycobacterial cytoplasmic antigen resulted in a decrease of the test specifity. Tuberculin testing and intracutaneous BCG-vaccination in healthy adults had no distinct influence on the antibody response against several mycobacterial test antigens. However, a rapid increase of antibody levels was documented in melanoma patients after BCG-immunotherapy by sacrification with a more concentrated vaccine.

Antibodies, Bacterial↗
PubMed1994

[Clinical course of tuberculosis in young children, vaccinated and non-vaccinated with BCG vaccine].

As shown by the analysis of tuberculosis forms in 27 infants under 1 year of age (group 1) and 150 infants of older age (group 2), the involvement of the intrathoracic lymph nodes holds the first place among tuberculosis forms encountered in infants. Severe infection (tuberculous meningitis, disseminated tuberculosis) occurred more frequently in group 1. The authors emphasize epidemiological significance of contacts with tuberculous patients. To decrease infant tuberculosis incidence rate, it is of much more importance to make early diagnosis in the adults, to give infants preventive treatment, chemoprophylaxis in particular, than to perform BCG vaccination under conditions of close contacts with tuberculous subjects.

Adult↗