Lawrence Adewale
Pharmaceutical Medicine, Bioluminux Clinical Research, Naperville, USA.
Cureus. 2024 Mar 21;16(3):e56643. doi: 10.7759/cureus.56643. eCollection 2024 Mar.
Bacillus Calmette-Guérin (BCG) vaccination remains a cornerstone in global efforts to combat tuberculosis (TB), a persistent public health threat worldwide. The purpose of this systematic review is to find out how well BCG revaccination protects against TB. This systematic review synthesized recent studies investigating the efficacy of BCG vaccination in preventing TB infection and disease. A total of 15 relevant publications were identified through a comprehensive search across multiple databases, including Cochrane Library, PubMed, Medline, and Scopus. The inclusion criteria encompassed studies involving humans, written in English, and categorized as case-control, cohort, meta-analysis, or full-text. Studies were selected based on their relevance to BCG revaccination and protection against TB, and a standardized data extraction form was used to gather pertinent information from each study. Quality assessment was conducted using established tools to evaluate the rigor, study design, and risk of bias in each included study. The findings revealed significant insights into BCG's effectiveness across different populations and age groups. Several studies demonstrated a substantial reduction in latent TB infection (LTBI) and incidence rates of TB following BCG vaccination. However, the protective efficacy of BCG revaccination varied across studies and populations, with some indicating modest protection against TB disease development, particularly in high-risk populations like healthcare workers. Furthermore, investigations into the immunological mechanisms underlying BCG's protective efficacy provided valuable insights into cytokine/chemokine profiles and immunomodulatory properties.
卡介苗(BCG)接种仍然是全球抗击结核病(TB)努力的基石,结核病是全球持续存在的公共卫生威胁。本系统评价的目的是了解卡介苗复种预防结核病的效果如何。本系统评价综合了近期调查卡介苗接种预防结核感染和疾病疗效的研究。通过对多个数据库(包括Cochrane图书馆、PubMed、Medline和Scopus)进行全面检索,共识别出15篇相关出版物。纳入标准包括涉及人类的研究、英文撰写的研究以及归类为病例对照、队列、荟萃分析或全文的研究。根据研究与卡介苗复种及预防结核病的相关性进行选择,并使用标准化数据提取表从每项研究中收集相关信息。使用既定工具进行质量评估,以评估每项纳入研究的严谨性、研究设计和偏倚风险。研究结果揭示了卡介苗在不同人群和年龄组中的有效性的重要见解。多项研究表明,卡介苗接种后潜伏性结核感染(LTBI)和结核病发病率大幅降低。然而,卡介苗复种的保护效果在不同研究和人群中有所不同,一些研究表明对结核病发病的保护作用有限,尤其是在医护人员等高风险人群中。此外,对卡介苗保护效果的免疫机制的研究为细胞因子/趋化因子谱和免疫调节特性提供了有价值的见解。