Department of Nephrology; Tongji Hospital/Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China.
Hum Vaccin Immunother. 2012 Dec 1;8(12):1802-7. doi: 10.4161/hv.21874. Epub 2012 Aug 24.
The utilization of immunosuppressive agents presents patients with autoimmune nephrosis at a high risk of infection. The present trial was to investigate the efficacy and safety of Broncho-Vaxom on preventing infection in immunosuppressive patients with autoimmune nephrosis.
40 patients with autoimmune nephrosis were randomly divided into two groups. The control group (20 cases) routinely received corticosteroid and (or) immunosuppressive therapy, while the treatment group (20 cases) received a capsule containing 7 mg Broncho-Vaxom daily for the first 10 d of each month for 3 consecutive months on the basis of conventional corticosteroid and (or) immunosuppressive therapy. The condition of infection and blood lymphocyte were assessed.
4 patients in the treatment group and 5 patients in the control group were lost during the follow-up period. 25% of patients in the treatment group and 40% of patients in the control group suffered infection. There was no difference in the incidence of infection between the two groups (p > 0.05), while Broncho-Vaxom treated patients suffered a shorter infection period and of which fewer patients need to receive antibiotics therapy (p < 0.05). After the treatment with Broncho-Vaxom, the total number of blood T lymphocyte, proportion of CD4 (+) T lymphocyte, CD4 (+) /CD8 (+) reduced less and the serum IgG rose more obviously (p < 0.05), but the blood lymphocyte, B lymphocyte, CD8 (+) T lymphocyte, IgA and IgM have no differences between the two groups (p > 0.05).
Broncho-Vaxom might be a good choice for preventing the respiratory infection in nephrosis, especially in the patients under the therapy of immunosuppressive agents.
免疫抑制剂的应用使自身免疫性肾病患者面临高感染风险。本试验旨在研究支气管疫苗(Broncho-Vaxom)预防自身免疫性肾病免疫抑制患者感染的疗效和安全性。
40 例自身免疫性肾病患者随机分为两组。对照组(20 例)常规接受皮质类固醇和(或)免疫抑制剂治疗,治疗组(20 例)在常规皮质类固醇和(或)免疫抑制剂治疗的基础上,于每月前 10 天每日口服 7mg Broncho-Vaxom 胶囊,连续 3 个月。评估感染情况和血淋巴细胞。
治疗组有 4 例和对照组有 5 例在随访期间失访。治疗组有 25%的患者和对照组有 40%的患者发生感染。两组感染发生率无差异(p>0.05),但 Broncho-Vaxom 治疗组感染期较短,需要接受抗生素治疗的患者较少(p<0.05)。Broncho-Vaxom 治疗后,血总 T 淋巴细胞数、CD4(+)T 淋巴细胞比例、CD4(+)/CD8(+)减少较少,血清 IgG 升高更明显(p<0.05),但两组间血淋巴细胞、B 淋巴细胞、CD8(+)T 淋巴细胞、IgA 和 IgM 无差异(p>0.05)。
Broncho-Vaxom 可能是预防肾病患者呼吸道感染的一种较好选择,特别是在接受免疫抑制剂治疗的患者中。