Can the Efficacy of Bacille Calmette‐Guérin Tuberculosis Vaccine Be Affected by Intestinal Parasitic Infections?

Ferreira, Ana Paula; Aguiar, Aline Silva de; Fava, Maycron W. B.; Corrêa, José Otávio Amaral; Teixeira, Francisco Martins; Teixeira, Henrique Couto

doi:10.1086/341656

Cited by 16 publications

(15 citation statements)

References 9 publications

(11 reference statements)

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“…Further, the above two factors significantly bias the type of immune response to vaccines towards Th2 type whereas the desired protective immune response for tuberculosis is Th1 type (3,4).…”

Section: Lettermentioning

confidence: 99%

Parameters that influence the prediction of epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnosis

Vani¹,

Maddur²,

Lacroix‐Desmazes³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

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Section: Lettermentioning

confidence: 99%

Parameters that influence the prediction of epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnosis

Vani¹,

Maddur²,

Lacroix‐Desmazes³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

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“…(29) The principal causes of the low efficiency of the BCG vaccine can be related to the following factors: 1) exposure to environmental mycobacteria; (30) 2) genetic variations in the target population or in the vaccine strains; (4) 3) nutritional differences among vaccinated individuals; (29) and 4) co-infections. (31) Nevertheless, in areas of low TB prevalence, vaccination is recommended for children (except for children with AIDS), immediately after birth or at the first contact with public health facilities, in order to prevent meningitis. (32) Despite continuous efforts to develop more efficacious vaccines against TB, no new vaccines have as yet been approved.…”

Section: Immune Response To M Tuberculosismentioning

confidence: 99%

Diagnóstico imunológico da tuberculose: problemas e estratégias para o sucesso

Teixeira

Abramo

Munk³

2007

J. bras. pneumol.

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Tuberculosis remains a serious social and public health problem, affecting millions of people annually. The bacille Calmette-Guerin (BCG) vaccine, used prophylactically, does not impede the progression of the disease, which usually manifests as decreased cellular immunity. Early diagnosis, together with polychemotherapy, can control the dissemination of the tuberculosis infection. The current diagnostic methods present certain problems. Such problems include the low sensitivity of sputum smear microscopy, the fact that performing microbiological cultures is quite time-consuming, and the low specificity of the skin test with the purified protein derivative of Mycobacterium tuberculosis.New diagnostic methods, which use specific antigens such as the early secreted antigenic target 6-kDa and culture filtrate protein 10-kDa, are being evaluated. The genes that encode these antigens are located in the DNA region of difference 1 of M. tuberculosis, M. africanum and M. bovis. However, they are absent from the M. bovis (BCG) and from most environmental mycobacteria. Diagnostic methods such as QuantiFERON-TB ® and T SPOT.TB ® , which are based on the production of interferon-gamma by T lymphocytes, in response to those antigens, are being tested and have been found to outstrip the purified protein derivative skin test in the following characteristics: greater sensitivity; lower cross-reactivity due to BCG vaccination or infection with environmental mycobacteria; and execution time. The introduction of diagnostic methods that are more specific and sensitive, together with gaining a better understanding of the molecular and cellular mechanisms that regulate the parasite-host interaction, can increase the efficiency of strategies devised to combat tuberculosis.

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“…3 For example, helminths are associated with impaired cellular immune response against human immunodeficiency virus (HIV), 4 malaria, and tuberculosis. 5 Chronic helminth infections are characterized by T-helper type-2 responses that may be permissive to helminth long-term survival. Intestinal helminth infections tend to modulate the immune response cytokine profile to a T-helper type-2 response, which may cause T-helper type-1 imbalance and consequently, diminished cellular immune response against tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

Tuberculin Skin-Test Reactions Are Unaffected by the Severity of Hyperendemic Intestinal Helminth Infections and Co-Infections

Zevallos

Vergara

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. The tuberculin skin test (TST) quantifies cell-mediated immunity to tuberculosis antigens. Helminths suppress cell-mediated immunity, so we studied the effect of helminth infection and deworming on the TST in a randomized, double-blind, placebo-controlled study in an indigenous Amazon community ( N = 195). Stool microscopy diagnosed helminths in 98% and co-infection with multiple species in 24% of study subjects. The TST was positive (≥ 10 mm) for 49%, and responses increased with age ( P < 0.001), Bacille Calmette Guerin (BCG) vaccination ( P = 0.01), and tuberculosis contact ( P = 0.05). TST results had no association with helminth-egg concentrations, species, or co-infections (all P > 0.1). One month after deworming with albendazole (three daily 400-mg doses), helminths were reduced, but 63% remained infected with helminths. Albendazole did not cause a change in TST size ( P = 0.8) or positivity ( P = 0.9) relative to placebo. Thus, TST reactions were unaffected by albendazole therapy that partially cured intestinal helminth infections, and TST interpretation was unaffected by high-burden helminth infections and co-infection with multiple helminth species.

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Can the Efficacy of Bacille Calmette‐Guérin Tuberculosis Vaccine Be Affected by Intestinal Parasitic Infections?

Cited by 16 publications

References 9 publications

Parameters that influence the prediction of epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnosis

Parameters that influence the prediction of epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnosis

Diagnóstico imunológico da tuberculose: problemas e estratégias para o sucesso

Tuberculin Skin-Test Reactions Are Unaffected by the Severity of Hyperendemic Intestinal Helminth Infections and Co-Infections

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