Allergy Asthma Immunol Res.  2011 Jul;3(3):178-185. 10.4168/aair.2011.3.3.178.

Personal Factors Affecting Therapeutic Responses to BCG Vaccination in Asthmatics

• Choi IS
• Han ER
• Kim YJ
• Yoon JY
• Kim SS
• Seo IK
• Jang YJ
• Park CS

• KMID: 1803323
• DOI: http://doi.org/10.4168/aair.2011.3.3.178

Abstract

PURPOSE
Bacille Calmette-Guerin (BCG) vaccination has been reported to be an effective treatment for asthma in several animal models. This study investigated whether the response to BCG treatment in asthma depends on subject clinical characteristics.
METHODS
Stable asthma patients were vaccinated with BCG. One month later, alterations in pulmonary function after vaccination and their relationships with subject clinical characteristics were determined.
RESULTS
Of 149 patients with asthma, 54 (36.2%) showed a good or fair response to BCG. The DeltaFEV1 after vaccination was significantly related to age (r=-0.348, P<0.001), peripheral blood eosinophil counts (r=0.315, P<0.001) and baseline FEV1, expressed as % personal best value (r=-0.474, P<0.001), but not to FEV1 % predicted value (r=-0.066, P>0.05). A good/fair response was highly prevalent in atopic females compared with atopic males, especially among those aged < or =50 years (90.9% vs. 40.0%, P=0.024). Age (P<0.001, odds ratios (OR)=0.92, confidence interval (CI)=0.88-0.96) and atopy (P<0.01, OR=4.95, CI=1.70-14.44) were significant predictors for a good/fair response in females. However, blood eosinophil counts (P<0.05, OR=1.18, CI=1.01-1.39) and FEV1 % best (P<0.001, OR=0.86, CI=0.79-0.94), but not age or atopy, were significant predictors in males. Approximately three-quarters of the males were smokers.
CONCLUSIONS
The therapeutic effect of BCG in asthma may differ according to patient clinical characteristics. The greatest benefit occurred in young atopic females. Asthma activity indices, such as eosinophilia and FEV1 % best, were more predictive of a good/fair response in males; this may have been related to cigarette smoking.

Keyword

Activity; asthma; atopy; BCG; gender; smoking

MeSH Terms

Aged
Asthma
Eosinophilia
Eosinophils
Female
Humans
Male
Models, Animal
Mycobacterium bovis
Odds Ratio
Smoking
Vaccination

Figure

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  Fig. 1 Relationship between the change in forced expiratory volume in 1 sec (FEV1) after BCG vaccination and age (left panel) or peripheral blood eosinophil % (right panel).

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  Fig. 2 Relationship between the change in forced expiratory volume in 1 sec (FEV1) after BCG vaccination and baseline FEV1 expressed as % predicted value (left panel) or % personal best value (right panel).

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  Fig. 3 Proportion of subjects who showed a good or fair response to BCG vaccination to total subjects among asthma patients with or without atopy (left panel) and in ≤50 year-old males and females with atopic asthma (right panel). Good or fair response: Δforced expiratory volume in 1 sec (FEV1) ≥6% and 100 mL or Δpeak expiratory flow (PEF) ≥10% and 30 L/min; atopy: wheal size of allergen >25% of that of histamine or allergen-specific IgE ≥0.35 kU/L (UniCAP).

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