Umar Tungki Pratama, Jain Nityanand, Stevanny Bella, Javed Binish, Priandhana Andyra, Siburian Reynold, Kostiks Andrejs
Division of Surgery and Interventional Science, Faculty of Medicine, University College London, London, UK.
Faculty of Medicine, Riga Stradinš University, Riga, LV 1007, Latvia.
Heliyon. 2024 Mar 6;10(5):e27425. doi: 10.1016/j.heliyon.2024.e27425. eCollection 2024 Mar 15.
Introduction: Alzheimer's disease (AD) represents a significant societal challenge, highlighting the need to explore effective prevention and treatment approaches. Recent literature has suggested that Bacillus Calmette-Guérin (BCG) vaccine may be a viable therapeutic option for immune disorders associated with AD due to its immunomodulatory properties and protection against various diseases.
This systematic review aimed to evaluate the association of BCG vaccine in the prevention of AD using six medical-scientific databases. A meta-analytical approach was undertaken to estimate the risk of AD incidence in patients with and without BCG vaccine exposure, followed by subgroup analyses. A risk of bias (RoB) assessment was performed using the Newcastle-Ottawa Scale (NOS).
Six cohort studies meeting our inclusion criteria were included (47,947 participants) in the study. From our meta-analysis, intravesical BCG vaccine administration lowered the risk of incidence of AD by 26% in non-muscle-invasive bladder cancer (p < 0.00001). Subgroup analyses showed that BCG vaccination showed a potentially notable preventive effect on AD in older adults (>75 years) and female participants. Conversely, significant heterogeneity in results was observed among male participants and those aged <75 years. The RoB was low in three studies and unclear in the remaining studies.
Although our results support the potential benefits of BCG vaccine in preventing AD in specific demographics, we remain cautious about interpreting such results. Further research examining the implications of BCG vaccination for prevention and possible treatment of AD should be undertaken in the future.
引言：阿尔茨海默病（AD）是一项重大的社会挑战，凸显了探索有效预防和治疗方法的必要性。最近的文献表明，卡介苗（BCG）疫苗因其免疫调节特性和对多种疾病的预防作用，可能是与AD相关的免疫疾病的一种可行治疗选择。
本系统评价旨在使用六个医学科学数据库评估卡介苗疫苗在预防AD方面的关联。采用荟萃分析方法估计接种和未接种卡介苗疫苗的患者发生AD的风险，随后进行亚组分析。使用纽卡斯尔-渥太华量表（NOS）进行偏倚风险（RoB）评估。
本研究纳入了六项符合我们纳入标准的队列研究（47947名参与者）。从我们的荟萃分析来看，膀胱内注射卡介苗疫苗可使非肌层浸润性膀胱癌患者发生AD的风险降低26%（p<0.00001）。亚组分析表明，卡介苗接种对75岁以上的老年人和女性参与者的AD具有潜在的显著预防作用。相反，在男性参与者和75岁以下的参与者中观察到结果存在显著异质性。三项研究的RoB较低，其余研究的RoB不明确。
尽管我们的结果支持卡介苗疫苗在预防特定人群AD方面的潜在益处，但我们对解释这些结果仍持谨慎态度。未来应开展进一步研究，探讨卡介苗接种对AD预防和可能治疗的影响。
