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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
  • Bernatowska, Ewa1
  • Skomska-Pawliszak, Małgorzta2
  • Wolska-Kuśnierz, Beata2
  • Pac, Małgorzata2
  • Heropolitanska-Pliszka, Edyta2
  • Pietrucha, Barbara2
  • Bernat-Sitarz, Katarzyna2
  • Dąbrowska-Leonik, Nel2
  • Bohynikova, Nadia2
  • Piątosa, Barbara3
  • Lutyńska, Anna4
  • Augustynowicz, Ewa5
  • Augustynowicz-Kopeć, Ewa6
  • Korzeniewska-Koseła, Maria7
  • Krasińska, Maria8
  • Krzysztopa-Grzybowska, Katarzyna9
  • Wieteska-Klimczak, Anna10
  • Książyk, Janusz10
  • Jackowska, Teresa11, 12
  • van den Burg, Mirjam13
  • And 4 more
  • 1 Department of Immunology, The Children's Memorial Health Institute, Warsaw, Poland. [email protected] , (Poland)
  • 2 Department of Immunology, The Children's Memorial Health Institute, Warsaw, Poland. , (Poland)
  • 3 Histocompatibility Laboratory, Children's Memorial Health Institute, Warsaw, Poland. , (Poland)
  • 4 Department of Medical Biology, The Cardinal Stefan Wyszyński Institute of Cardiology, Warsaw, Poland. , (Poland)
  • 5 Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland. , (Poland)
  • 6 Department of Microbiology, National Tuberculosis Reference Laboratory, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland. , (Poland)
  • 7 Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland. , (Poland)
  • 8 Department of Tuberculosis and Lung Disease, Mazovian Centre for Tuberculosis and Lung Disease, Otwock, Poland. , (Poland)
  • 9 Department of Sera and Vaccines Evaluation, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland. , (Poland)
  • 10 Department of Paediatrics, Nutrition and Metabolic Diseases, Children's Memorial Health Institute, Warsaw, Poland. , (Poland)
  • 11 Department of Paediatrics, Medical Centre of Postgraduate Education, Warsaw, Poland. , (Poland)
  • 12 Department of Paediatrics, Bielanski Hospital, Warsaw, Poland. , (Poland)
  • 13 Department of Immunohematology and Blood Transfusion (IHB), Leiden University Medical Center (LUMC), 2333, Leiden, ZA, Netherlands. , (Netherlands)
  • 14 St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA.
  • 15 Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR 1163, Necker Hospital for Sick Children, Paris, France. , (France)
  • 16 Paediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France. , (France)
  • 17 Howard Hughes Medical Institute, New York, NY, USA.
  • 18 Paris Descartes University, Imagine Institute, Paris, France. , (France)
  • 19 Study Centre for Primary Immunodeficiency, Necker-Enfants Malades Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France. , (France)
  • 20 Department of Paediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Białystok, Poland. , (Poland)
Type
Published Article
Journal
Journal of Clinical Immunology
Publisher
Springer-Verlag
Publication Date
Nov 20, 2019
Identifiers
DOI: 10.1007/s10875-019-00709-1
PMID: 31749033
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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). 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 TB+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. 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.

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