Ruso Salvador, Marco Francisco M, Martínez-Carbonell Juan A, Carratalá José A
Servicio de Neumología, Hospital Vega Baja, Orihuela, Alicante, Spain.
R&D Department, Immunal S.A.U., Madrid, Spain.
APMIS. 2015 Jul;123(7):556-61. doi: 10.1111/apm.12386. Epub 2015 May 22.
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Exacerbation episodes impair lung function leading to disease progression. Levels of inflammation markers correlate with disease severity. Bacterial immunomodulators have shown a beneficial effect in COPD, improving symptoms and reducing the rate of exacerbations. This is an observational prospective study on 30 patients diagnosed with bronchiectasis and COPD, who received bacterial autogenous vaccine for 12 months. The rate of exacerbation, severity of symptoms and lung function were studied at baseline and after treatment. In addition, plasma levels CRP, IL6, IL8, and TNFα were measured. After treatment we found a reduction in mean acute respiratory infections and signs of lung disease. Acute phase proteins IL6 and CRP increased in blood and IL8 decreased. These changes may be related to the repeated injection of inactivated bacteria. Given the implication of these factors in the pathogenesis of COPD, particularly the production of IL8, the causes and consequences of cytokine modulation by bacterial vaccines should be investigated. Vaccination with autogenous vaccines for 1 year can produce a significant clinical improvement in COPD patients, reducing the frequency of exacerbations associated to changes in the profile of markers of inflammation.
慢性阻塞性肺疾病（COPD）是全球范围内导致死亡和发病的主要原因。急性加重发作会损害肺功能，导致疾病进展。炎症标志物水平与疾病严重程度相关。细菌免疫调节剂已在COPD中显示出有益作用，可改善症状并降低急性加重率。这是一项针对30例诊断为支气管扩张症和COPD的患者的观察性前瞻性研究，这些患者接受了12个月的细菌自体疫苗接种。在基线和治疗后研究了急性加重率、症状严重程度和肺功能。此外，还测量了血浆中CRP、IL6、IL8和TNFα的水平。治疗后，我们发现平均急性呼吸道感染和肺部疾病体征有所减少。急性期蛋白IL6和CRP在血液中增加，而IL8减少。这些变化可能与灭活细菌的重复注射有关。鉴于这些因素在COPD发病机制中的作用，特别是IL8的产生，应研究细菌疫苗对细胞因子调节的原因和后果。接种自体疫苗1年可使COPD患者的临床状况得到显著改善，减少与炎症标志物谱变化相关的急性加重频率。
