Doupis John, Kolokathis Konstantinos, Markopoulou Eftychia, Efthymiou Vasiliki, Festas George, Papandreopoulou Vasiliki, Kallinikou Chrysoula, Antikidou Despina, Gemistou Golfo, Angelopoulos Theodoros
Internal Medicine and Diabetes Department, Salamis Naval and Veterans Hospital, Salamis, Greece.
Iatriko Paleou Falirou Medical Center, Diabetes Clinic, Athens, Greece.
Diabetes Ther. 2021 Nov;12(11):2971-2976. doi: 10.1007/s13300-021-01163-2. Epub 2021 Oct 1.
Bacille Calmette-Guérin (BCG) vaccination has shown promising therapeutic effects for type 1 diabetes (T1D). According to recent studies, immunometabolism modification and regulation of T lymphocytes constitute the proposed mechanisms by which BCG vaccination may delay T1D onset. Clinical trial evidence from Turkey supports that two to three doses of the BCG vaccine in childhood, with the first dose administered in the first year of life, may prevent T1D. In the same study, one or zero vaccinations appeared to have no effect in T1D onset prevention. In Greece, the BCG vaccine was administered in a single dose at the age of 9 years in elementary school. BCG vaccination was not performed on a mandatory basis, creating one BCG vaccinated and one non-vaccinated population. The aim of our study was to investigate the possible effect of a single dose of BCG vaccine, at the age of 9 years, on the time of T1D onset, in a population of BCG vaccinated and non-vaccinated patients with diagnosed T1D.
To test this hypothesis, a survey through the Pan-Hellenic Federation of People with Diabetes (PFPD) was performed. In this observational, retrospective study, participating patients provided information regarding age, gender, time of diagnosis, and BCG vaccination status. Patients diagnosed with T1D before the age of 9 years were excluded from the analysis.
The final sample included 196 patients (73 male and 123 female) with a mean age of 42.2 ± 14.3 years and a mean duration of diabetes of 16.8 ± 12.9 years. Mean age of T1D diagnosis in the BCG vaccinated group was 24.0 ± 19.0 years, while the mean age of T1D diagnosis in the BCG non-vaccinated group was 21.5 ± 14.3 years (p = 0.03). No interaction was found between gender and the age of diagnosis for BCG vaccinated and unvaccinated patients (p = 0.86).
The results of our study suggest that a single dose of BCG vaccine, performed at the age of 9 years, may delay the onset of T1D by 2.5 years. Additional studies of children receiving multiple doses of BCG should be conducted to possibly prove prolongation of the disease-free interval.
卡介苗（BCG）接种已显示出对1型糖尿病（T1D）有良好的治疗效果。根据最近的研究，免疫代谢的改变和T淋巴细胞的调节构成了卡介苗接种可能延迟T1D发病的推测机制。来自土耳其的临床试验证据支持，儿童期接种两到三剂卡介苗，第一剂在一岁时接种，可能预防T1D。在同一研究中，接种一剂或未接种卡介苗似乎对预防T1D发病没有效果。在希腊，卡介苗在小学9岁时接种一剂。卡介苗接种并非强制进行，从而形成了一个接种卡介苗和一个未接种卡介苗的人群。我们研究的目的是调查9岁时接种一剂卡介苗对已确诊T1D的接种和未接种卡介苗患者群体中T1D发病时间的可能影响。
为验证这一假设，通过希腊糖尿病患者泛希腊联合会（PFPD）进行了一项调查。在这项观察性回顾性研究中，参与的患者提供了有关年龄、性别、诊断时间和卡介苗接种状况的信息。9岁前被诊断为T1D的患者被排除在分析之外。
最终样本包括196名患者（73名男性和123名女性），平均年龄为42.2±14.3岁，糖尿病平均病程为16.8±12.9年。接种卡介苗组T1D诊断的平均年龄为24.0±19.0岁，而未接种卡介苗组T1D诊断的平均年龄为21.5±14.3岁（p = 0.03）。在接种和未接种卡介苗的患者中，未发现性别与诊断年龄之间存在相互作用（p = 0.86）。
我们的研究结果表明,9岁时接种一剂卡介苗可能使T1D发病延迟2.5年。应开展更多关于儿童接种多剂卡介苗的研究，以可能证明无病期的延长。
