Division of Allergy, Chonnam National University Hospital, Gwangju, Korea.
Allergy Asthma Immunol Res. 2011 Jul;3(3):178-85. doi: 10.4168/aair.2011.3.3.178. Epub 2011 May 18.
Bacille Calmette-Guérin (BCG) vaccination has been reported to be an effective treatment for asthma in several animal models. This study investigated whether the response to BCG treatment in asthma depends on subject clinical characteristics.
Stable asthma patients were vaccinated with BCG. One month later, alterations in pulmonary function after vaccination and their relationships with subject clinical characteristics were determined.
Of 149 patients with asthma, 54 (36.2%) showed a good or fair response to BCG. The ΔFEV1 after vaccination was significantly related to age (r=-0.348, P<0.001), peripheral blood eosinophil counts (r=0.315, P<0.001) and baseline FEV1, expressed as % personal best value (r=-0.474, P<0.001), but not to FEV1 % predicted value (r=-0.066, P>0.05). A good/fair response was highly prevalent in atopic females compared with atopic males, especially among those aged ≤50 years (90.9% vs. 40.0%, P=0.024). Age (P<0.001, odds ratios (OR)=0.92, confidence interval (CI)=0.88-0.96) and atopy (P<0.01, OR=4.95, CI=1.70-14.44) were significant predictors for a good/fair response in females. However, blood eosinophil counts (P<0.05, OR=1.18, CI=1.01-1.39) and FEV1 % best (P<0.001, OR=0.86, CI=0.79-0.94), but not age or atopy, were significant predictors in males. Approximately three-quarters of the males were smokers.
The therapeutic effect of BCG in asthma may differ according to patient clinical characteristics. The greatest benefit occurred in young atopic females. Asthma activity indices, such as eosinophilia and FEV1 % best, were more predictive of a good/fair response in males; this may have been related to cigarette smoking.
卡介苗（BCG）接种已被报道在几种动物模型中对哮喘有治疗作用。本研究旨在探讨哮喘患者对 BCG 治疗的反应是否取决于患者的临床特征。
稳定期哮喘患者接受 BCG 接种。接种 1 个月后，评估接种后肺功能的变化，并分析其与患者临床特征的关系。
149 例哮喘患者中，54 例（36.2%）对 BCG 治疗有良好或中等反应。接种后 FEV1 的变化与年龄（r=-0.348，P<0.001）、外周血嗜酸性粒细胞计数（r=0.315，P<0.001）和基础 FEV1 占个人最佳值的百分比（r=-0.474，P<0.001）显著相关，而与 FEV1 占预计值的百分比（r=-0.066，P>0.05）无关。与男性相比，女性的特应性哮喘患者中，对 BCG 治疗有良好/中等反应的患者比例更高，尤其是年龄≤50 岁的患者（90.9%比 40.0%，P=0.024）。年龄（P<0.001，比值比（OR）=0.92，95%置信区间（CI）=0.88-0.96）和特应性（P<0.01，OR=4.95，CI=1.70-14.44）是女性中良好/中等反应的显著预测因素。然而，在男性中，外周血嗜酸性粒细胞计数（P<0.05，OR=1.18，CI=1.01-1.39）和 FEV1 占最佳值的百分比（P<0.001，OR=0.86，CI=0.79-0.94），而不是年龄或特应性，是良好/中等反应的显著预测因素。约 70%的男性为吸烟者。
BCG 治疗哮喘的疗效可能因患者的临床特征而异。在年轻的特应性女性中获益最大。在男性中，哮喘活动指数（如嗜酸性粒细胞增多和 FEV1 占最佳值的百分比）对良好/中等反应的预测作用更大，这可能与吸烟有关。
