Starshinova Anna, Kudryavtsev Igor, Rubinstein Artem, Dovgalyuk Irina, Kulpina Anastasia, Churilov Leonid P, Kudlay Dmitry
Department of Mathematics and Computer Science, Saint Petersburg State University, St. Petersburg, Russia.
Medical Department, Saint Petersburg State University, St. Petersburg, Russia.
Front Pediatr. 2025 Jul 31;13:1603732. doi: 10.3389/fped.2025.1603732. eCollection 2025.
Tuberculosis (TB) remains a fatal disease primarily transmitted through airborne droplets, with children who are the most susceptible, particularly in the areas with poor tuberculosis control. The BCG vaccine, developed by Albert Calmette and Camille Guérin, has a history spanning a century. This vaccine has been implemented in numerous countries, significantly reducing child mortality in regions heavily affected by TB. In this review, we aim to revisit the vaccine's development and rollout, while also highlighting its current attributes and the successful application in the Russian Federation, where 90% of newborns receive the anti-tuberculosis vaccination. Due to that practice, only a few isolated cases of young children with generalized tuberculosis (about five to seven annually) are observed in Russia. Research on the BCG vaccine is ongoing, revealing significant genetic alterations in BCG strains that have evolved from the original variant. These genetic differences may contribute to variations in vaccine efficacy, making screening important to predict effectiveness. The BCG vaccine can initiate a localized mucosal immune response, offering, besides the anti-TB effect, some protection against infections involving mucous membranes, including salmonellosis, HIV, and acute viral respiratory infections. It is essential to investigate the role of BCG in various applications; however, this exploration should not detract from its main protective benefits against tuberculosis (TB). Future studies may provide evidence of the vaccine's safety and efficacy to support its use beyond TB prevention. While BCG vaccination does not lower the risk of infection with , it does prevent the progression to the most severe clinical manifestations (such as miliary TB and tuberculous meningitis) caused by hematogenous spread of . The challenge of protecting HIV-infected children from TB remains urgent, especially in regions burdened with drug-resistant TB, highlighting the need for robust protective measures.
结核病（TB）仍然是一种主要通过空气飞沫传播的致命疾病，儿童是最易感染的群体，尤其是在结核病控制不力的地区。由阿尔贝·卡尔梅特（Albert Calmette）和卡米耶·介兰（Camille Guérin）研发的卡介苗（BCG）已有百年历史。该疫苗已在许多国家推行，显著降低了结核病高发地区儿童的死亡率。在本综述中，我们旨在回顾该疫苗的研发与推广情况，同时突出其当前特性以及在俄罗斯联邦的成功应用，在俄罗斯，90%的新生儿接种了抗结核病疫苗。由于这一举措，俄罗斯每年仅观察到少数几例幼儿全身性结核病病例（约五至七例）。对卡介苗的研究仍在进行，研究发现卡介苗菌株与原始变体相比发生了显著的基因改变。这些基因差异可能导致疫苗效力的差异，因此进行筛选对于预测有效性很重要。卡介苗可引发局部黏膜免疫反应，除了具有抗结核作用外，还能为涉及黏膜的感染提供一定保护，包括沙门氏菌病、艾滋病毒和急性病毒性呼吸道感染。研究卡介苗在各种应用中的作用至关重要；然而，这种探索不应减损其对结核病的主要保护益处。未来的研究可能会提供该疫苗安全性和有效性的证据，以支持其在结核病预防之外的应用。虽然卡介苗接种并不能降低感染[此处原文缺失病原体名称]的风险，但它确实可以预防由[此处原文缺失病原体名称]血行播散引起的最严重临床表现（如粟粒性结核病和结核性脑膜炎）。保护感染艾滋病毒的儿童免受结核病侵害的挑战依然紧迫，尤其是在耐药结核病负担较重的地区，这凸显了采取有力保护措施的必要性。
