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Noishiki C, Hayasaka Y, Yoshida R, Ogawa R. Over 90% Percent of Childhood BCG Vaccine-Induced Keloids in Japan Occur in Women. Dermatol Ther (Heidelb) 2023; 13:1137-1147. [PMID: 36952124 PMCID: PMC10034230 DOI: 10.1007/s13555-023-00916-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/06/2023] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Keloids are a fibroproliferative, multifactorial, cutaneous disorder whose pathophysiology is not completely understood. Various factors such as high blood pressure, pregnancy, female gender, mechanical tension of local sites, and prolonged wound healing are known to worsen keloids. Childhood-onset keloids are keloids that form before 10 years of age, before various factors in adulthood come into play, and thus studying childhood-onset keloids may provide additional insight into the underlying mechanisms that lead to keloid formation. METHODS Retrospective chart review was performed on all patients with childhood-onset keloids who were evaluated at our plastic surgery clinic (one of the largest keloid referral centers in Japan) over a 1-year period. RESULTS Of the 1443 patients with diagnosis of keloids, 131 patients had childhood-onset keloids. Of these, 106 patients (80.9%) were female, 38.9% of patients had family history of keloids, and 48.9% of patients had allergies or allergy-related conditions (asthma, atopic dermatitis, or allergic rhinitis). Vaccination (47.5%) and chickenpox (19.9%) were the most common triggers. Of vaccinations, BCG was the most common trigger. The majority of keloids from BCG were in female patients (92.9%). The most common location was the chest in male patients (30.0%) and the arm in female patients (41.1%). CONCLUSION To our knowledge, this is the largest report in the literature on childhood-onset keloids. There was overall female predominance in childhood-onset keloids, and even more significant female predominance in BCG-induced keloids.
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Affiliation(s)
- Chikage Noishiki
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-Ku, Tokyo, 113-8603, Japan
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Ryu Yoshida
- Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-Ku, Tokyo, 113-8603, Japan.
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2
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Gong W, Mao Y, Li Y, Qi Y. BCG Vaccination: A potential tool against COVID-19 and COVID-19-like Black Swan incidents. Int Immunopharmacol 2022; 108:108870. [PMID: 35597119 PMCID: PMC9113676 DOI: 10.1016/j.intimp.2022.108870] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 12/17/2022]
Abstract
The severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), the causative agent of the coronavirus
disease 2019 (COVID-19), and its variants have brought unprecedented
impacts to the global public health system, politics, economy, and other
fields. Although more than ten COVID-19 specific vaccines have been
approved for emergency use, COVID-19 prevention and control still face
many challenges. Bacille Calmette–Guérin (BCG) is the only authorized
vaccine used to fight against tuberculosis (TB), it has been hypothesized
that BCG may prevent and control COVID-19 based on BCG-induced
nonspecific immune responses. Herein, we summarized: 1) The nonspecific
protection effects of BCG, such as prophylactic protection effects of BCG
on nonmycobacterial infections, immunotherapy effects of BCG vaccine, and
enhancement effect of BCG vaccine on unrelated vaccines; 2) Recent
evidence of BCG's efficacy against SARS-COV-2 infection from ecological
studies, analytical analyses, clinical trials, and animal studies; 3)
Three possible mechanisms of BCG vaccine and their effects on COVID-19
control including heterologous immunity, trained immunity, and
anti-inflammatory effect. We hope that this review will encourage more
scientists to investigate further BCG induced non-specific immune
responses and explore their mechanisms, which could be a potential tool
for addressing the COVID-19 pandemic and COVID-19-like “Black Swan”
events to reduce the impacts of infectious disease outbreaks on public
health, politics, and economy.
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Affiliation(s)
- Wenping Gong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8(th) Medical Center of PLA General Hospital, Beijing 100091, China
| | - Yingqing Mao
- Huadong Research Institute for Medicine and Biotechniques, Nanjing 210002, Jiangsu Province, China
| | - Yuexi Li
- Huadong Research Institute for Medicine and Biotechniques, Nanjing 210002, Jiangsu Province, China.
| | - Yong Qi
- Huadong Research Institute for Medicine and Biotechniques, Nanjing 210002, Jiangsu Province, China.
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3
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White AD, Sibley L, Sarfas C, Morrison AL, Bewley K, Churchward C, Fotheringham S, Gkolfinos K, Gooch K, Handley A, Humphries HE, Hunter L, Kennard C, Longet S, Mabbutt A, Moffatt M, Rayner E, Tipton T, Watson R, Hall Y, Bodman-Smith M, Gleeson F, Dennis M, Salguero FJ, Carroll M, McShane H, Cookson W, Hopkin J, Sharpe S. Influence of Aerosol Delivered BCG Vaccination on Immunological and Disease Parameters Following SARS-CoV-2 Challenge in Rhesus Macaques. Front Immunol 2022; 12:801799. [PMID: 35222355 PMCID: PMC8863871 DOI: 10.3389/fimmu.2021.801799] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/24/2021] [Indexed: 12/19/2022] Open
Abstract
The tuberculosis vaccine, Bacille Calmette-Guerin (BCG), also affords protection against non-tuberculous diseases attributable to heterologous immune mechanisms such as trained innate immunity, activation of non-conventional T-cells, and cross-reactive adaptive immunity. Aerosol vaccine delivery can target immune responses toward the primary site of infection for a respiratory pathogen. Therefore, we hypothesised that aerosol delivery of BCG would enhance cross-protective action against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and be a deployable intervention against coronavirus disease 2019 (COVID-19). Immune parameters were monitored in vaccinated and unvaccinated rhesus macaques for 28 days following aerosol BCG vaccination. High-dose SARS-CoV-2 challenge was applied by intranasal and intrabronchial instillation and animals culled 6–8 days later for assessment of viral, disease, and immunological parameters. Mycobacteria-specific cell-mediated immune responses were detected following aerosol BCG vaccination, but SARS-CoV-2-specific cellular- and antibody-mediated immunity was only measured following challenge. Early secretion of cytokine and chemokine markers associated with the innate cellular and adaptive antiviral immune response was detected following SARS-CoV-2 challenge in vaccinated animals, at concentrations that exceeded titres measured in unvaccinated macaques. Classical CD14+ monocytes and Vδ2 γδ T-cells quantified by whole-blood immunophenotyping increased rapidly in vaccinated animals following SARS-CoV-2 challenge, indicating a priming of innate immune cells and non-conventional T-cell populations. However, viral RNA quantified in nasal and pharyngeal swabs, bronchoalveolar lavage (BAL), and tissue samples collected at necropsy was equivalent in vaccinated and unvaccinated animals, and in-life CT imaging and histopathology scoring applied to pulmonary tissue sections indicated that the disease induced by SARS-CoV-2 challenge was comparable between vaccinated and unvaccinated groups. Hence, aerosol BCG vaccination did not induce, or enhance the induction of, SARS-CoV-2 cross-reactive adaptive cellular or humoral immunity, although an influence of BCG vaccination on the subsequent immune response to SARS-CoV-2 challenge was apparent in immune signatures indicative of trained innate immune mechanisms and primed unconventional T-cell populations. Nevertheless, aerosol BCG vaccination did not enhance the initial clearance of virus, nor reduce the occurrence of early disease pathology after high dose SARS-CoV-2 challenge. However, the heterologous immune mechanisms primed by BCG vaccination could contribute to the moderation of COVID-19 disease severity in more susceptible species following natural infection.
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Affiliation(s)
- Andrew D White
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Laura Sibley
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Charlotte Sarfas
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Alexandra L Morrison
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Kevin Bewley
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Colin Churchward
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Susan Fotheringham
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Konstantinos Gkolfinos
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Karen Gooch
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Alastair Handley
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Holly E Humphries
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Laura Hunter
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Chelsea Kennard
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Stephanie Longet
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Adam Mabbutt
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Miriam Moffatt
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Emma Rayner
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Tom Tipton
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Robert Watson
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Yper Hall
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Mark Bodman-Smith
- Infection and Immunity Research Institute, St George's University of London, London, United Kingdom
| | - Fergus Gleeson
- Department of Oncology, Churchill Hospital, Oxford, United Kingdom
| | - Mike Dennis
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Francisco J Salguero
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Miles Carroll
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
| | - Helen McShane
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - William Cookson
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Julian Hopkin
- College of Medicine, Institute of Life Science, Swansea University, Swansea, United Kingdom
| | - Sally Sharpe
- Research and Evaluation, United Kingdom Health Security Agency, Salisbury, United Kingdom
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Chinnaswamy S. SARS-CoV-2 infection in India bucks the trend: Trained innate immunity? Am J Hum Biol 2021; 33:e23504. [PMID: 32965717 PMCID: PMC7536963 DOI: 10.1002/ajhb.23504] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/26/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2, the causative agent of COVID-19 pandemic caught the world unawares by its sudden onset in early 2020. Memories of the 1918 Spanish Flu were rekindled raising extreme fear for the virus, but in essence, it was the host and not the virus, which was deciding the outcome of the infection. Age, gender, and preexisting conditions played critical roles in shaping COVID-19 outcome. People of lower socioeconomic strata were disproportionately affected in industrialized countries such as the United States. India, a developing country with more than 1.3 billion population, a large proportion of it being underprivileged and with substandard public health provider infrastructure, feared for the worst outcome given the sheer size and density of its population. Six months into the pandemic, a comparison of COVID-19 morbidity and mortality data between India, the United States, and several European countries, reveal interesting trends. While most developed countries show curves expected for a fast-spreading respiratory virus, India seems to have a slower trajectory. As a consequence, India may have gained on two fronts: the spread of the infection is unusually prolonged, thus leading to a curve that is "naturally flattened"; concomitantly the mortality rate, which is a reflection of the severity of the disease has been relatively low. I hypothesize that trained innate immunity, a new concept in immunology, may be the phenomenon behind this. Biocultural, socioecological, and socioeconomic determinants seem to be influencing the outcome of COVID-19 in different regions/countries of the world.
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Affiliation(s)
- Sreedhar Chinnaswamy
- Infectious Disease GeneticsNational Institute of Biomedical GenomicsKalyaniIndia
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5
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Su WJ, Chang CH, Wang JL, Chen SF, Yang CH. COVID-19 Severity and Neonatal BCG Vaccination among Young Population in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4303. [PMID: 33919644 PMCID: PMC8074147 DOI: 10.3390/ijerph18084303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Data have not been reported to explore the relation between COVID-19 severity and BCG vaccination status at the individual patient level. METHODS Taiwan has a nationwide neonatal BCG vaccination program that was launched in 1965. The Taiwan Centers for Disease Control established a web-based National Immunization Information System (NISS) in 2003 and included all citizens' BCG vaccination records in NISS for those born after 1985. We identified COVID-19 Taiwanese patients born after 1985 between 21 January and 19 March 2021. Study participants were further classified into ages 4-24 years (birth year 1996-2016) and 25-33 years (birth year 1986-1995). We described their clinical syndrome defined by the World Health Organization and examined the relation between the COVID-19 severity and BCG vaccination status. RESULTS In the 4-24 age group, among 138 BCG vaccinated individuals, 80.4% were asymptomatic or had mild disease, while 17.4% had moderate disease, 1.5% had severe disease, and 0.7% had acute respiratory distress syndrome but none of them died. In contrast, all 6 BCG unvaccinated individuals in this age group experienced mild illness. In the 25-33 age group, moderate disease occurred in 14.2% and severe disease occurred in 0.9% of the 106 patients without neonatal BCG vaccination records, as compared to 19.2% had moderate disease and none had severe or critical disease of the 78 patients with neonatal BCG vaccination records. CONCLUSIONS Our finding indicated that BCG immunization might not relate to COVID-19 severity in the young population.
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Affiliation(s)
- Wei-Ju Su
- Centers for Disease Control, Ministry of Health and Welfare, Taipei 100, Taiwan; (W.-J.S.); (S.-F.C.)
| | - Chia-Hsuin Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan;
| | - Jiun-Ling Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 701, Taiwan;
| | - Shu-Fong Chen
- Centers for Disease Control, Ministry of Health and Welfare, Taipei 100, Taiwan; (W.-J.S.); (S.-F.C.)
| | - Chin-Hui Yang
- Centers for Disease Control, Ministry of Health and Welfare, Taipei 100, Taiwan; (W.-J.S.); (S.-F.C.)
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6
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Chugh A, Khera D, Khasbage S, Singh S. Does bacille calmette–Guérin vaccination provides protection against COVID-19: A systematic review and meta-analysis. Indian J Community Med 2021; 46:592-599. [PMID: 35068716 PMCID: PMC8729290 DOI: 10.4103/ijcm.ijcm_952_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Lower morbidity and mortality in few geographic locations on the globe suffering with SARS-CoV-2 has been associated with the existing or previously followed long-standing Bacille Calmette–Guérin (BCG) vaccination policy among infants. However, does it hold true that today after years of BCG vaccination, few adults have better prognosis or is it just confounding due to differential disease burden, population density, testing facilities, or improper reporting. The purpose was to evaluate and correlate this effect systematically. Methods: Detailed electronic search for randomized controlled trials (RCTs) and observational studies in PubMed, Cochrane Library, and ClinicalTrials.gov for eligible studies was performed. Results: One hundred and fourteen studies were yielded on search strategy and 28 observational studies were finally included for analysis. From our results, we can say that BCG vaccination causes a decrease in COVID-19 incidence and mortality. However, these results must be interpreted cautiously as lot of confounding factors were present in included studies, which can affect the outcome. Conclusion: The evidence of BCG vaccination for the protection against COVID-19 cannot be ruled out as evidence from many studies support the hypothesis, but the evidence of well-conducted RCTs and observational studies can strengthen the evidence. Registration Number: PROSPERO (International Prospective Register of Systematic Reviews) database (CRD42020204466).
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7
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Kalyuzhin OV, Andronova TM, Karaulov AV. [BCG, muramylpeptides, trained immunity (part I): linkages in the light of the COVID-19 pandemic]. TERAPEVT ARKH 2020; 92:195-200. [PMID: 33720594 DOI: 10.26442/00403660.2020.12.200464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/07/2021] [Indexed: 11/22/2022]
Abstract
It has long been known that Bacillus CalmetteGurin (BCG) vaccine provides nonspecific protection against many non-mycobacterial infections, which has been discussed in the last decade through the prism of the concept of trained immunity. Within the framework of this concept, a persistent increase in resistance to various pathogens, which occurs after an infectious disease or exposure to certain microbial agents, is associated with epigenetic reprogramming of innate immune cells and their bone marrow progenitors. The COVID-19 pandemic has drawn attention of scientists and practitioners to BCG as an inducer of trained immunity. A number of epidemiological studies have suggested a negative association between the coverage of the population with BCG vaccination and the burden of SARS-CoV-2 infection. A series of independent clinical studies of the effectiveness of this vaccine in non-specific prevention of COVID-19 has been initiated in different countries. Recently, the key role of cytosolic NOD2 receptors in BCG-induced trained immunity has been proven. This actualizes the search for effective immunoactive preparations for prevention of respiratory infections in the pandemic among low molecular weight peptidoglycan fragments of the bacterial cell wall, muramylpeptides (MPs), which are known to be NOD2 agonists. The review highlights the proven and proposed linkages between BCG, MPs, NOD2 and trained immunity in the light of the COVID-19 pandemic. Analysis of the data presented indicates the prospects for preclinical and clinical studies of MPs as potential drugs for nonspecific prevention of SARS-CoV-2 infection and/or other respiratory infections in risk groups during the pandemic. First of all, attention should be paid to glucosaminylmuramyl dipeptide, approved for clinical use in Russia and a number of post-Soviet countries for the complex treatment and prevention of acute and recurrent respiratory infections.
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Affiliation(s)
- O V Kalyuzhin
- Sechenov First Moscow State Medical University (Sechenov University)
| | | | - A V Karaulov
- Sechenov First Moscow State Medical University (Sechenov University)
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8
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Sarinho E, Goudouris E, Solé D. BCG vaccine: Worrying proposal for COVID-19. Vaccine 2020; 39:460-462. [PMID: 33341305 PMCID: PMC7745307 DOI: 10.1016/j.vaccine.2020.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/27/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022]
Abstract
Bacille Calmette-Guérin (BCG) vaccine is proven to be effective in protecting against severe tuberculosis. It has been suggested to be able to exert a non-specific beneficial effect as protection against other infectious diseases. The duration of protection against tuberculosis is estimated to be from 10 to 15 years, but the duration of the protection against other infections is not known, maybe up to 20 years, maybe much shorter than that. We don’t know it for sure. BCG induced trained immunity paradigm is based on experimental models, cohort studies with low number of individuals, and some epidemiological data in which other possible interfering factors are not controlled. The titles and scopes of scientific articles should be cautiously considered as they can promote indications of getting vaccinated or revaccinated with BCG, before its effectiveness is confirmed and recommendations are published. Besides, revaccination with BCG can put at serious risk patients with primary or secondary immunodeficiency. Maybe BCG vaccine is effective in preventing COVID-19 deaths or reducing its severity, but may the effect of this vaccine be relevant even with poor health politics and assistance? It is very difficult to compare the epidemiologic data about COVID-19 in different countries. There are countless factors, mainly social and related to the healthcare system, which can be more decisive than the hypothesis of trained immunity induced by BCG. Until now, we can say that BCG’s protective role is, at least, insufficient, given many other factors that corroborate SARS-CoV-2 infection and/or its severity.
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Affiliation(s)
- Emanuel Sarinho
- Federal University of Pernambuco (UFPE), Avenida Parnamirim n° 327 ap 1303, ZC 52060-000 Recife, Pernambuco, Brazil
| | - Ekaterini Goudouris
- Federal University of Rio de Janeiro (UFRJ), Rua Professor Luis Cantanhede n° 77 ap 101, ZC 22245-040 Rio de Janeiro, RJ, Brazil.
| | - Dirceu Solé
- Federal University of São Paulo State (UNIFESP), Rua Mirassol n° 236 ap72, ZC 04044-010 São Paulo, SP, Brazil
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9
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Szigeti R, Kellermayer D, Trakimas G, Kellermayer R. BCG epidemiology supports its protection against COVID-19? A word of caution. PLoS One 2020; 15:e0240203. [PMID: 33027297 PMCID: PMC7540851 DOI: 10.1371/journal.pone.0240203] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/23/2020] [Indexed: 01/12/2023] Open
Abstract
The COVID-19 pandemic, caused by type 2 Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), puts all of us to the test. Epidemiologic observations could critically aid the development of protective measures to combat this devastating viral outbreak. Recent observations, linked nation based universal Bacillus Calmette-Guerin (BCG) vaccination to potential protection against morbidity and mortality from SARS-CoV-2, and received much attention in public media. We wished to validate the findings by examining the country based association between COVID-19 mortality per million population, or daily rates of COVID-19 case fatality (i.e. Death Per Case/Days of the endemic [dpc/d]) and the presence of universal BCG vaccination before 1980, or the year of the establishment of universal BCG vaccination. These associations were examined in multiple regression modeling based on publicly available databases on both April 3rd and May 15th of 2020. COVID-19 deaths per million negatively associated with universal BCG vaccination in a country before 1980 based on May 15th data, but this was not true for COVID-19 dpc/d on either of days of inquiry. We also demonstrate possible arbitrary selection bias in such analyses. Consequently, caution should be exercised amidst the publication surge on COVID-19, due to political/economical-, arbitrary selection-, and fear/anxiety related biases, which may obscure scientific rigor. We argue that global COVID-19 epidemiologic data is unreliable and therefore should be critically scrutinized before using it as a nidus for subsequent hypothesis driven scientific discovery.
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Affiliation(s)
- Reka Szigeti
- Department of Pathology & Genomic Medicine, Houston Methodist Hospital, Houston, Texas, United States of America
| | | | - Giedrius Trakimas
- Institute of Biosciences, Vilnius University, Vilnius, Latvia
- Institute of Life Sciences and Technology, Daugavpils University, Daugavpils, Latvia
| | - Richard Kellermayer
- Section of Pediatric Gastroenterology, Texas Children’s Hospital, Houston, Texas, United States of America
- Baylor College of Medicine, Houston, Texas, United States of America
- USDA/ARS Children’s Nutrition Research Center, Houston, Texas, United States of America
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10
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COVID-19 in Light of Seasonal Respiratory Infections. BIOLOGY 2020; 9:biology9090240. [PMID: 32825427 PMCID: PMC7564908 DOI: 10.3390/biology9090240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/23/2022]
Abstract
A wide diversity of zoonotic viruses that are capable of overcoming host range barriers facilitate the emergence of new potentially pandemic viruses in the human population. When faced with a new virus that is rapidly emerging in the human population, we have a limited knowledge base to work with. The pandemic invasion of the new SARS-CoV-2 virus in 2019 provided a unique possibility to quickly learn more about the pathogenesis of respiratory viruses. In this review, the impact of pandemics on the circulation of seasonal respiratory viruses is considered. The emergence of novel respiratory viruses has often been accompanied by the disappearance of existing circulating strains. Some issues arising from the spread of pandemic viruses and underlying the choices of a strategy to fight the coronavirus infection are discussed.
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11
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Tomita Y, Sato R, Ikeda T, Sakagami T. BCG vaccine may generate cross-reactive T cells against SARS-CoV-2: In silico analyses and a hypothesis. Vaccine 2020; 38:6352-6356. [PMID: 32863070 PMCID: PMC7440160 DOI: 10.1016/j.vaccine.2020.08.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/13/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
BCG contains similar 9-amino acid sequences with SARS-CoV-2. The peptides have moderate to high binding affinity to common HLA class I molecules. Cross-reactive T cells against SARS-CoV-2 could be generated by BCG vaccination.
The world is facing the rising emergency of SARS-CoV-2. The outbreak of COVID-19 has caused a global public health and economic crisis. Recent epidemiological studies have shown that a possible association of BCG vaccination program with decreased COVID-19-related risks, suggesting that BCG may provide protection against COVID-19. Non-specific protection against viral infections is considered as a main mechanism of BCG and clinical trials to determine whether BCG vaccine can protect healthcare workers from the COVID-19 are currently underway. We hypothesized that BCG may carry similar T cell epitopes with SARS-CoV-2 and evaluated the hypothesis by utilizing publicly available database and computer algorithms predicting human leukocyte antigen (HLA) class I‐binding peptides. We found that BCG contains similar 9-amino acid sequences with SARS-CoV-2. These closely-related peptides had moderate to high binding affinity for multiple common HLA class I molecules, suggesting that cross-reactive T cells against SARS-CoV-2 could be generated by BCG vaccination.
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Affiliation(s)
- Yusuke Tomita
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan.
| | - Ryo Sato
- Laboratory of Stem Cell and Neuro-Vascular Biology, Genetics and Developmental Biology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, United States
| | - Tokunori Ikeda
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Sojo University, Japan; Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, Japan
| | - Takuro Sakagami
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan
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12
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Wassenaar TM, Buzard GS, Newman DJ. BCG vaccination early in life does not improve COVID-19 outcome of elderly populations, based on nationally reported data. Lett Appl Microbiol 2020; 71:498-505. [PMID: 32734625 DOI: 10.1111/lam.13365] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 01/08/2023]
Abstract
The reported numbers of Covid-19 cases and deaths were compared for 18 countries (14 in Western Europe, plus Australia, Brazil, Israel and the USA) to assess the effect of historic and current national BCG immunizations. In view of the high death rate for Covid-19 patients over 70 years of age, and given the fact that BCG vaccination is typically given early in life, we compared countries that had introduced BCG in the 1950s with those that had not. No effect on Covid-19 case fatality rate (CFR) or number of deaths per population could be demonstrated. Since some countries test for Covid-19 more than others, the effect of tests performed per million population on reported deaths per million was also assessed, but again did not demonstrate an effect of BCG vaccination in the 1950s. Whether countries had never used the vaccine, had historically used it but since ceased to do so, or were presently vaccinating with BCG did not correlate with national total number of deaths or CFR. We conclude that there is currently no evidence for a beneficial effect of BCG vaccination on Covid-19 reported cases or fatalities.
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Affiliation(s)
- T M Wassenaar
- Molecular Microbiology and Genomics Consultants, Zotzenheim, Germany
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