Identifying Predictors of Interferon-γ Release Assay Results in Pediatric Latent Tuberculosis: A Protective Role of Bacillus Calmette-Guérin?

Roy, Robindra Basu; Sotgiu, Giovanni; Altet-Gómez, Neus; Τσολιά, Μαρία; Ruga, Ezia; Velizarova, Svetlana; Kampmann, Beate

doi:10.1164/rccm.201201-0026oc

Cited by 90 publications

(40 citation statements)

References 34 publications

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“…[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] A recent meta-analysis of the efficacy of BCG vaccine against the pulmonary, meningeal and disseminated forms of TB included 21 randomized or quasi-randomized clinical trials: 18 involving patients with pulmonary TB, and 6 involving patients with meningeal and/or military forms. 30 The panel marginally supports a recommendation for use subjects vaccinated at birth (RR 0.41, 95% CI 0,29-0.58).…”

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

“…26 Basu Roy et al estimated the correlation of BCG and IGRA positivity with vaccine administration. 27 The analysis included children who had been in domestic contact with cases of active TB, children tested for LTBI after having recently emigrated from highly endemic countries, and (in the case of Greece and Spain) children who were positive upon universal screening. It therefore seems to be clear that the vaccination also protects against LTBI.…”

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

“…It therefore seems to be clear that the vaccination also protects against LTBI. 27 Eisenhut et al used an IGRA to test the school contacts of a child with non-infectious pulmonary in the UK and found that BCG vaccine (a single dose administered at birth using the Danish strain 1331) protected against both LTBI and active disease (adjusted RR of LTBI 0.61, 95% CI 0.39-0.96 [a 38% reduction in RR]; adjusted RR of active TB 0.51, 95% CI 0.15-1.70). 28 After adjusting for ethnicity, closeness in class and shared activities, BCG vaccination continued to show a protective effect against infection (OR 0.16, 95% CI 0.05-0.54), with a corrected RR of 26% (95% CI 0.09-0.69) corresponding to a 74% reduction in RR (95% CI 31-91%).…”

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

“…44 However, many pediatric studies have not found any significant difference in the rates of TST positivity between vaccinated and unvaccinated children. 45 The bibliographical search identified 6 cohort studies that have evaluated the effect of BCG vaccine on TST responses, 27,29,[47][48][49] and recent studies comparing the TST and IGRA responses of vaccinated subjects have shown that BCG vaccination does affect TST positivity. 27,29,46 A multicentre study by .…”

Section: Does Bcg Vaccination Affect Tst Responses?mentioning

confidence: 99%

“…45 The bibliographical search identified 6 cohort studies that have evaluated the effect of BCG vaccine on TST responses, 27,29,[47][48][49] and recent studies comparing the TST and IGRA responses of vaccinated subjects have shown that BCG vaccination does affect TST positivity. 27,29,46 A multicentre study by . 27 Vaccinated children showed significantly larger areas of hardening (median 14 mm; interquartile range 10-17 mm) than unvaccinated children (median 10 mm; interquartile range 0-14 mm; p < 0.001).…”

Section: Does Bcg Vaccination Affect Tst Responses?mentioning

confidence: 99%

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Recommendations for pediatric tuberculosis vaccination in Italy

Montagnani

Esposito

Galli

et al. 2015

Human Vaccines & Immunotherapeutics

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Bacillus Calmette-Guerin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged <6 months, and all TST-negative children aged between 6 months and 5 y who come from highly epidemic areas, or whose parents come from highly endemic areas, or who have been in contact with a family member with active TB without contracting the disease themselves.

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Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

Section: Does Bcg Vaccination Affect Tst Responses?mentioning

confidence: 99%

Section: Does Bcg Vaccination Affect Tst Responses?mentioning

confidence: 99%

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Recommendations for pediatric tuberculosis vaccination in Italy

Montagnani

Esposito

Galli

et al. 2015

Human Vaccines & Immunotherapeutics

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Cytomegalovirus‐specific T cells are detectable in early childhood and allow assignment of the infection status in children with passive maternal antibodies

et al. 2013

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Serological identification of the cytomegalovirus (CMV) status in children less than 18 months of age is complicated by the variable persistence of maternal antibodies. As T cells are not passively transferred, we attempted to assess whether CMV-specific cellular immunity may be superior to determine the actual CMV status; we also performed a functional characterization of T-cell immunity in childhood. Antibodies from 59 mothers and 168 children were determined, and specific CD4 + T cells were identified by induction of IFN-γ, IL-2, TNF-α, IL-4, and IL-17 after CMV-specific and polyclonal stimulation. Agreement between both tests was perfect for mothers and children more than 18 months. Among infants less than 18 months, 17/30 were concordantly negative. Interestingly, 8/13 seropositive children had detectable CMV-specific T cells, whereas only 5/13 were T-cell negative, indicating passive immunity. CMV-specific T cells from young infants differed in cytokine profiles from that of older age groups, and polyclonal effector T-cell frequencies were higher in young infants with detectable CMV-specific T cells compared with those without. In conclusion, the majority of young infants with CMV-specific antibodies show evidence of true infection, which indicates that passive immunity is overestimated. Our data may have important implications for improved risk stratification and CMV management in infants in the setting of transplantation. Keywords IntroductionComplications related to cytomegalovirus (CMV) are among the most serious infectious complications after organ transplantation Correspondence: Prof. Martina Sester e-mail: martina.sester@uks.eu in both adults and children [1][2][3]. The risk for CMV infection and disease largely depends on the CMV status of the donor and the recipient, which is determined prior to transplantation based on CMV serology. While the determination of CMV-specific humoral * These authors contributed equally to this work. Eur. J. Immunol. 2013. 43: 1099-1108 immunity is a reliable and widely used method to determine evidence of prior infection, it has limitations in clinical situations where passive antibodies may exist due to transfusion of plasma products or due to natural existence of maternal antibodies in young infants. This raises uncertainty as to the correct assignment of the CMV status in recipients or donors after plasma transfusion or in children below the age of 18 months. Based on this uncertainty, current guidelines recommend that the highest risk should be assumed for any transplant arrangement where passive antibody titers may exist in either the donor or the recipient, i.e. the recipient should always be assumed as CMV-negative and the donor should be considered as CMVpositive [1,2]. Based on this clinical dilemma, the development of alternative approaches to assess the actual infection status was recently defined as an important research priority to improve posttransplant management in children [1].We have previously shown in adults that the determination of CMV-specifi...

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Potential Immunology, Transcriptomics and Epigenomic Prediction Tools of the Future to Improve tuberculosis Control

DiNardo

Mandalakas

2019

Tuberculosis Host-Pathogen Interactions

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Identifying Predictors of Interferon-γ Release Assay Results in Pediatric Latent Tuberculosis: A Protective Role of Bacillus Calmette-Guérin?

Cited by 90 publications

References 34 publications

Recommendations for pediatric tuberculosis vaccination in Italy

Recommendations for pediatric tuberculosis vaccination in Italy

Cytomegalovirus‐specific T cells are detectable in early childhood and allow assignment of the infection status in children with passive maternal antibodies

Potential Immunology, Transcriptomics and Epigenomic Prediction Tools of the Future to Improve tuberculosis Control

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