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BMJ:卡介苗新用途:抵御感染性疾病的发生

来源:生物谷 2014-08-08 14:40

2014年8月8日 讯 /生物谷BIOON/ --近日,一项刊登在国际杂志BMJ上的研究论文中,来自英国伦敦大学的研究人员通过研究表示,用于抵御结核分枝杆菌感染的卡介苗(BCG)或许可以帮助抵御其它感染性疾病的发生,早在几十年前卡介苗已经经过了许多临床试验和研究,其可以帮助儿童有效抵御多种形式的结核病的感染,有效率高达60%-80%。

这项研究中,研究者发现,卡介苗或许还可以帮助机体抵御别的感染性疾病,研究者对1950年至2013年间来自循证医学库中的数据进行分析,所有的研究对象均在16岁以下,其中包括BCG免疫过的和未免疫过的。前期研究者的分析主要是研究是否卡介苗和接触结核杆菌的儿童未发生感染相关。

文章中研究人员工队3855名参与者进行了分析,结果发现,相比为接种过的个体来讲,接种过卡介苗的个体抵御感染有效性为19%;更有意思的是,研究者还根据国家地处纬度不同进行了研究,研究者发现生活在纬度40度的国家比如英国、西班牙等国家的个体,其接种卡介苗后帮助抵御机体感染的有效性为20%,而生活在20-40度以及0-20度纬度国家的个体却并不会因注射卡介苗而带来任何保护效应。

最后,研究者Ibrahim Abubakar说道,卡介苗的注射给个体带来的效应或许因每个国家肺结核发病率的不同而表现出不同,而且由于国家对出生接种疫苗政策的不同,因此未来卡介苗的接种对个体将是非常有益的,未来研究人员将通过更为深入的研究来调查新型抵御肺结核感染的疫苗对机体的有益效应。(生物谷Bioon.com)

Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis

A Roy, senior scientist1, M Eisenhut, consultant paediatrician2, R J Harris, statistician1, L C Rodrigues, professor of epidemiology3, S Sridhar, research associate4, S Habermann, junior doctor2, L Snell, junior doctor2, P Mangtani, senior lecturer3, I Adetifa, paediatrician and medical epidemiologist5, A Lalvani, professor of infectious disease4, I Abubakar, professor of infectious disease epidemiology16

Objectives To determine whether BCG vaccination protects against Mycobacterium tuberculosis infection as assessed by interferon γ release assays (IGRA) in children. Design Systematic review and meta-analysis. Searches of electronic databases 1950 to November 2013, checking of reference lists, hand searching of journals, and contact with experts. Setting Community congregate settings and households. Inclusion criteria Vaccinated and unvaccinated children aged under 16 with known recent exposure to patients with pulmonary tuberculosis. Children were screened for infection with M tuberculosis with interferon γ release assays. Data extraction Study results relating to diagnostic accuracy were extracted and risk estimates were combined with random effects meta-analysis. Results The primary analysis included 14 studies and 3855 participants. The estimated overall risk ratio was 0.81 (95% confidence interval 0.71 to 0.92), indicating a protective efficacy of 19% against infection among vaccinated children after exposure compared with unvaccinated children. The observed protection was similar when estimated with the two types of interferon γ release assays (ELISpot or QuantiFERON). Restriction of the analysis to the six studies (n=1745) with information on progression to active tuberculosis at the time of screening showed protection against infection of 27% (risk ratio 0.73, 0.61 to 0.87) compared with 71% (0.29, 0.15 to 0.58) against active tuberculosis. Among those infected, protection against progression to disease was 58% (0.42, 0.23 to 0.77). Conclusions BCG protects against M tuberculosis infection as well as progression from infection to disease. Trial registration PROSPERO registration No CRD42011001698 (www.crd.york.ac.uk/prospero/).

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