[PDF][PDF] H4: IC31 vaccine or BCG revaccination for tuberculosis

C Bree, R Crevel, MG Netea - 2018 - repository.ubn.ru.nl
C Bree, R Crevel, MG Netea
2018repository.ubn.ru.nl
To the Editor: Nemes and colleagues (July 12 issue) 1 examined the effects of bacille
Calmette–Guérin (BCG) revaccination on reducing the rate of sustained QuantiFERON-TB
Gold In-tube assay (QFT) conversion among adolescents in a highrisk setting. One aspect
that received relatively little attention in the trial regards the immunologic mechanisms
responsible for these effects, which were assessed only by measurement of interferon-γ and
interleukin-2 T-cell responses. Studies have shown a combination of improved long-term …
To the Editor: Nemes and colleagues (July 12 issue) 1 examined the effects of bacille Calmette–Guérin (BCG) revaccination on reducing the rate of sustained QuantiFERON-TB Gold In-tube assay (QFT) conversion among adolescents in a highrisk setting. One aspect that received relatively little attention in the trial regards the immunologic mechanisms responsible for these effects, which were assessed only by measurement of interferon-γ and interleukin-2 T-cell responses. Studies have shown a combination of improved long-term innate or trained immunity (through epigenetic reprogramming of myeloid cells) and adaptive responses after BCG vaccination, which leads to more effective control of mycobacterial and unrelated infections. 2-4 These mechanisms can also explain the decrease in unrelated respiratory tract infections after BCG revaccination that was observed by the authors. This decrease is consistent with the nonspecific beneficial effects after BCG vaccination that have been observed repeatedly in persons included in epidemiologic studies, 5 especially in infants, and warrants sustained attention in future investigations.
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