The Natural Effect of BCG Vaccination on COVID-19: The Debate Continues

Gong, Wenping; An, Hongyu; Wang, Jie; Cheng, Ping; Qi, Yong

doi:10.3389/fimmu.2022.953228

Cited by 13 publications

(11 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Vaccination is the most effective way to prevent and control TB. The Bacillus Calmette-Guérin (BCG), the only licensed TB vaccine, had an excellent protective effect against miliary pulmonary tuberculosis and tuberculous meningitis in children ( 4 , 5 ). However, its defensive efficiency for adult TB is very poor (0%-80%), and the protection period of BCG only maintains 10~20 years ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

Bioinformatics analysis and consistency verification of a novel tuberculosis vaccine candidate HP13138PB

et al. 2023

Self Cite

View full text Add to dashboard Cite

BackgroundWith the increasing incidence of tuberculosis (TB) and the shortcomings of existing TB vaccines to prevent TB in adults, new TB vaccines need to be developed to address the complex TB epidemic.MethodThe dominant epitopes were screened from antigens to construct a novel epitope vaccine termed HP13138PB. The immune properties, structure, and function of HP13138PB were predicted and analyzed with bioinformatics and immunoinformatics. Then, the immune responses induced by the HP13138PB were confirmed by enzyme-linked immunospot assay (ELISPOT) and Th1/Th2/Th17 multi-cytokine detection kit.ResultThe HP13138PB vaccine consisted of 13 helper T lymphocytes (HTL) epitopes, 13 cytotoxic T lymphocytes (CTL) epitopes, and 8 B-cell epitopes. It was found that the antigenicity, immunogenicity, and solubility index of the HP13138PB vaccine were 0.87, 2.79, and 0.55, respectively. The secondary structure prediction indicated that the HP13138PB vaccine had 31% of α-helix, 11% of β-strand, and 56% of coil. The tertiary structure analysis suggested that the Z-score and the Favored region of the HP13138PB vaccine were -4.47 88.22%, respectively. Furthermore, the binding energies of the HP13138PB to toll-like receptor 2 (TLR2) was -1224.7 kcal/mol. The immunoinformatics and real-world experiments showed that the HP13138PB vaccine could induce an innate and adaptive immune response characterized by significantly higher levels of cytokines such as interferon-gamma (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and IL-10.ConclusionThe HP13138PB is a potential vaccine candidate to prevent TB, and this study preliminarily evaluated the ability of the HP13138PB to generate an immune response, providing a precursor target for developing TB vaccines.

show abstract

Section: Introductionmentioning

confidence: 99%

Bioinformatics analysis and consistency verification of a novel tuberculosis vaccine candidate HP13138PB

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…In contrast, some early clinical trials show no effect of BCG vaccination on COVID-19 infection [ 52 , 53 ]. Because of the conflicting nature of the results, these data should be interpreted with utmost prudence [ 54 ]. It is therefore still recommended that further studies be continued to map the true effect of BCG vaccination against COVID-19, especially with the rise of variants and the possibility of waning immunity with the current vaccines [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Bacille Calmette-Guerin vaccination policies in reducing infection and mortality of COVID-19: a systematic review

Obnial

Suzuki²,

Escuadra³

et al. 2022

glob health res policy

View full text Add to dashboard Cite

Background COVID-19 vaccination has been advocated as the most effective way to curb the pandemic. But with its inequitable distribution and slow rollout, especially in low- to middle- income countries, it will still take a long time before herd immunity is achieved. Alternative measures must therefore be explored to bolster current COVID-19 vaccination efforts. In particular, the Bacille Calmette-Guerin vaccine has been studied extensively as to its proposed conferment of non-specific immunity against different infections, including COVID-19. The aim of this study, therefore, is to evaluate the current evidence on the effectiveness of national BCG vaccination policies in reducing infection and mortality of COVID-19. Methods A systematic review was conducted between April to August 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA-P) guidelines. Literature was retrieved from PubMed, Cochrane, HERDIN, Web of Science, EBSCO, and Western Pacific Region Index Medicus (WPRIM). Studies conducted from January 2020 to August 2021 that fell within Level 1A to 2C of the Oxford Center for Evidence-Based Medicine were included in the review. Quality assessment was performed using the appropriate Joanna Briggs Institute critical appraisal tool and a quality assessment checklist for ecological studies adapted from Betran et al. Results A total of 13 studies were included in this review. Nine studies reported significant association between BCG vaccination policies and COVID-19 outcomes, even when controlling for confounding variables. In addition, among other mandated vaccines, such as pneumococcal, influenza, diphtheria-tetanus-pertussis, and measles, only BCG vaccination showed significant association with decreased COVID-19 adverse outcomes. However, other factors also showed positive association with COVID-19 outcomes, particularly markers of high economic status of countries, higher median age, and greater population densities. Conclusion The lower incidence and mortality of COVID-19 in countries with mandated BCG vaccination may not solely be attributable to BCG vaccination policies, but there is still some evidence that demonstrates a possible protective effect. Clinical trials must be continued before recommendations of BCG vaccinations are to be used as an alternative or booster vaccine against COVID-19.

show abstract

“…Bacille Calmette-Guérin (BCG), developed by Calmette and Guerin by attenuating the virulence of Mycobacterium bovis in 1908, is a century-old vaccine for TB prevention ( 3 ). BCG has an excellent protective effect on miliary tuberculosis and tuberculous meningitis in children or infants, but its protective efficacy in adults varies between 0% - 80% ( 4 , 5 ). In 1995, the WHO did not recommend BCG revaccination because of the lack of sufficient scientific evidence on the protective efficiency induced by BCG revaccination, and the Chinese Health Commission also stopped the work related to BCG revaccination in adults in 1997 ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…In 1995, the WHO did not recommend BCG revaccination because of the lack of sufficient scientific evidence on the protective efficiency induced by BCG revaccination, and the Chinese Health Commission also stopped the work related to BCG revaccination in adults in 1997 (6). Interestingly, a growing number of studies have demonstrated that BCG could induce a nonspecific memory immunity termed "trained immunity" in innate immune cells by activating higher frequencies of innate immune cells to secrete interleukin 1b (IL-1b), tumor necrosis factor a (TNF-a), and IL-6 cytokines (5,(7)(8)(9)(10)(11)(12). Therefore, the hypothesis has been proposed that BCG-induced trained immunity can protect against infection with microorganisms other than Mycobacterium tuberculosis (M. tb) (13,14).…”

mentioning

confidence: 99%

Research progress on specific and non-specific immune effects of BCG and the possibility of BCG protection against COVID-19

Su²,

Wang³

et al. 2023

Front. Immunol.

Self Cite

View full text Add to dashboard Cite

Bacille Calmette-Guérin (BCG) is the only approved vaccine for tuberculosis (TB) prevention worldwide. BCG has an excellent protective effect on miliary tuberculosis and tuberculous meningitis in children or infants. Interestingly, a growing number of studies have shown that BCG vaccination can induce nonspecific and specific immunity to fight against other respiratory disease pathogens, including SARS-CoV-2. The continuous emergence of variants of SARS-CoV-2 makes the protective efficiency of COVID-19-specific vaccines an unprecedented challenge. Therefore, it has been hypothesized that BCG-induced trained immunity might protect against COVID-19 infection. This study comprehensively described BCG-induced nonspecific and specific immunity and the mechanism of trained immunity. In addition, this study also reviewed the research on BCG revaccination to prevent TB, the impact of BCG on other non-tuberculous diseases, and the clinical trials of BCG to prevent COVID-19 infection. These data will provide new evidence to confirm the hypotheses mentioned above.

show abstract

The Natural Effect of BCG Vaccination on COVID-19: The Debate Continues

Cited by 13 publications

References 56 publications

Bioinformatics analysis and consistency verification of a novel tuberculosis vaccine candidate HP13138PB

Bioinformatics analysis and consistency verification of a novel tuberculosis vaccine candidate HP13138PB

Effectiveness of Bacille Calmette-Guerin vaccination policies in reducing infection and mortality of COVID-19: a systematic review

Research progress on specific and non-specific immune effects of BCG and the possibility of BCG protection against COVID-19

Contact Info

Product

Resources

About