Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
J Allergy Clin Immunol. 2011 Jan;127(1):246-53, 253.e1-21. doi: 10.1016/j.jaci.2010.07.039. Epub 2010 Oct 8.
There is conflicting evidence on whether BCG vaccination might represent an effective primary preventative strategy against the development of allergic sensitization and disease.
We sought to systematically review the relationship between BCG vaccination and the risk of sensitization, eczema/atopic dermatitis, allergic rhinoconjunctivitis, asthma, and other allergic conditions, such as food allergy and anaphylaxis.
Four international databases were searched for published epidemiologic or interventional studies. Additional online study databases were searched and vaccine manufacturers and a panel of international experts were contacted in an attempt to locate unpublished or ongoing studies. Quality assessment was undertaken by using internationally established criteria. Meta-analyses were undertaken by using fixed- or random-effects modeling. Funnel plots were used to assess for the risk of publication bias.
We identified 767 articles, of which 17 satisfied our inclusion criteria; there was only 1 randomized controlled trial, with the remaining studies being epidemiologic investigations. Meta-analyses did not show any protective effect of vaccination against the risk of sensitization, as judged by specific IgE tests (odds ratio [OR], 1.31; 95% CI, 1.07-1.60) or skin prick testing (OR, 0.87; 95% CI, 0.67-1.13); the risk of atopic eczema/dermatitis (OR, 0.84; 95% CI, 0.64-1.09); or the risk of allergic rhinoconjunctivitis (OR, 1.07; 95% CI, 0.89-1.28). BCG vaccination was associated with a protective effect against the risk of asthma (OR, 0.73; 95% CI, 0.56-0.95), although this might be explained by publication bias.
BCG vaccination is unlikely to be associated with protection against the risk of allergic sensitization and disease. The observed possible benefit in relation to the development of asthma is unlikely to be due to allergic sensitization.
卡介苗（BCG）接种是否可能成为预防过敏致敏和疾病发展的有效初级预防策略，目前存在相互矛盾的证据。
我们旨在系统回顾卡介苗接种与致敏、特应性皮炎/湿疹、变应性鼻结膜炎、哮喘和其他过敏疾病（如食物过敏和过敏反应）风险之间的关系。
检索了四个国际数据库中发表的流行病学或干预研究。还检索了其他在线研究数据库，并联系了疫苗制造商和一组国际专家，以寻找未发表或正在进行的研究。使用国际公认的标准进行质量评估。使用固定或随机效应模型进行荟萃分析。使用漏斗图评估发表偏倚的风险。
我们共确定了 767 篇文章，其中 17 篇符合纳入标准；仅有 1 项随机对照试验，其余研究为流行病学调查。荟萃分析显示，接种疫苗对特定 IgE 检测（比值比 [OR]，1.31；95%可信区间 [CI]，1.07-1.60）或皮肤点刺试验（OR，0.87；95%CI，0.67-1.13）的致敏风险、特应性湿疹/皮炎（OR，0.84；95%CI，0.64-1.09）或变应性鼻结膜炎（OR，1.07；95%CI，0.89-1.28）无保护作用。BCG 接种与哮喘风险降低（OR，0.73；95%CI，0.56-0.95）相关，但这可能是由发表偏倚造成的。
BCG 接种不太可能与预防过敏致敏和疾病的风险相关。观察到的与哮喘发生相关的可能获益不太可能是由于过敏致敏引起的。
