Published in:
Open Access
01-01-2020 | Primary Immunodeficiency | Original Article
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
Authors:
Ewa Bernatowska, Małgorzta Skomska-Pawliszak, Beata Wolska-Kuśnierz, Małgorzata Pac, Edyta Heropolitanska-Pliszka, Barbara Pietrucha, Katarzyna Bernat-Sitarz, Nel Dąbrowska-Leonik, Nadia Bohynikova, Barbara Piątosa, Anna Lutyńska, Ewa Augustynowicz, Ewa Augustynowicz-Kopeć, Maria Korzeniewska-Koseła, Maria Krasińska, Katarzyna Krzysztopa-Grzybowska, Anna Wieteska-Klimczak, Janusz Książyk, Teresa Jackowska, Mirjam van den Burg, Jacques J. M. van Dongen, Jean-Laurent Casanova, Capucine Picard, Bożena Mikołuć
Published in:
Journal of Clinical Immunology
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Issue 1/2020
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Abstract
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.