Impact of Bacille Calmette-Guérin revaccination on serum IgE levels in a randomized controlled trial

Peleteiro, Thaís Silva; Oliveira, Evelin Santos; Conceição, Elisabete Lopes; Nascimento-Sampaio, Francisco; Alcântara-Neves, Neuza Maria; Mendes, Carlos Mauricio Cardeal; Bessa, Theolis Costa Barbosa

doi:10.1590/0037-8682-0081-2017

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Short Communication • Rev. Soc. Bras. Med. Trop. 51 (01) • Jan-Feb 2018 • https://doi.org/10.1590/0037-8682-0081-2017 linkcopy

Impact of Bacille Calmette-Guérin revaccination on serum IgE levels in a randomized controlled trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION: Bacille Calmette-Guérin (BCG) downmodulates allergen-specific IgE levels and prevents other atopic responses in experimental models but fails to protect against respiratory allergies. Human responsiveness to BCG is variable and may interfere with protection.

METHODS: Multivariate models were evaluated to test the possible effect of responsiveness (assessed by IFN-γ production) to BCG revaccination on the modulation of total and allergen-specific serum IgE levels in healthy volunteers participating in a randomized controlled trial.

RESULTS: Serum total or Derp-specific IgE levels did not change regardless of the increase in IFN-γ levels.

CONCLUSIONS: BCG responsiveness does not affect protection against atopy.

Keywords:
Allergy; Atopy; Tuberculosis vaccine

	Revaccinated (n=46)^a		Controls (n=29)^b
	atopic (n =29)	non-atopic (n =16)	(atopic n =17)	non-atopic (n =11)
Age in years (95% CI)^c	20 (19-21)	20 (19-21)	20 (17-23)	20 (18-22)
Gender (%)
male	9 (31.0)	2 (12.0)	5 (29.0)	4 (36.0)
female	20 (69.0)	14 (88.0)	12 (71.0)	7 (64.0)
Family income > 5 MW^d (%)	22 (76.0)	11 (69.0)	13 (76.0)	8 (73.0)
n/a	1 (3.0)	0 (0.0)0	1 (6.0)	0 (0.0)
Smoking (%) yes	2 (7.0)	0 (0.0)	0 (0.0)	0 (0.0)
n/a	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Drug use (%)
alcohol^e	8 (28.0)	6 (38.0)	1 (6.0)	3 (27.0)
other^f	1 (3.0)	0 (0.0)	0 (0.0)	0 (0.0)
n/a	3 (10.0)	0 (0.0)	0 (0.0)	0 (0.0)
Parasitic disease
yes	3 (10.0)	1 (6.0)	2 (12.0)	0 (0.0)
no	13 (45.0)	8 (50.0)	8 (47.0)	5 (45.0)
n/a	13 (45.0)	7 (44.0)	7 (41.0)	6 (55.0)
BMI^g (95% CI)^c	21.0 (20.1-22.0)	20.3 (19.2-21.3)	21.3 (19.6-23)	20.4 (18.8-22.0)
BCG^h scar size from revaccination in mm (95% CI)^c	8.3 (6.3-10.2)	7.4 (4.1-10.8)	-	-
Current medication use (%)
antihistamine	0 (0.0)	1 (6.0)	0 (0.0)	0 (0.0)
corticosteroid	0 (0.0)	0 (0.0)	1 (6.0)	0 (0.0)
other non-related	6 (21.0)	3 (19.0)	3 (18.0)	2 (18.0)
none	23 (79.0)	12 (75.0)	13 (76.0)	9 (82.0)
Allergy (%)ⁱ
asthma/wheezing	6 (21.0)	2 (12.0)	4 (24.0)	2 (18.0)
rhinitis/sneezing	16 (55.0)	4 (25.0)	16 (94.0)	2 (18.0)
rhinitis/sneezing combined with asthma/wheezing	2 (7.0)	1 (3.0)	1 (6.0)	1 (9.0)
dermatitis/eczema	5 (17.0)	2 (12.0)	1 (6.0)	0 (0.0)
not allergic	8 (28.0)	11 (69.0)	1 (6.0)	8 (73.0)
n/a	1 (3.0)	0 (0.0)	0 (0.0)	0 (0.0)
Allergy symptoms in the past 12 months (%)ⁱ	13 (45.0)	5 (31.0)	13 (76.0)	3 (27.0)
n/a	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Atopy (%)
to any allergen in the SPT^j	17 (59.0)	-	8 (47.0)	-
to Derp^k in the SPT	24 (83.0)	-	14 (82.0)	-
SPT conversion 2 months after intervention*	-	1 (6.0)	-	1 (9.0)
Total IgE (ng/ml)^c
baseline (T0)	90.0 (45.4-134.5)	19.4 (3.2-35.7)	23.6 (10.8-36.5)	21.4 (2.2-40.6)
two months after intervention (T2)	66.7 (36.0-97.4)	21.9 (7.9-36.0)	34.4 (8.9-60.0)	25.5 (1.8-49.2)
Anti-Derp IgE (kU/ml)^c
baseline (T0)	29.40 (13.18-45.63)	0.00 (0.00-0.00)	23.70 (6.54-40.85)	0.00 (0.00-0.00)
two months after intervention (T2)	29.3 (10.5-48.0)	0.12 (-0.10 to -0.33)	8.09 (-2.69 to -18.87)	0.22 (-0.47 to -0.90)

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[TFN1] 95% CI: 95% confidence intervals; MW: minimum wage; n/a: information not available; BMI: body mass index; BCG: Bacille Calmette-Guérin; ISAAC: International Study of Asthma and Allergies in Childhood; SPT: skin prick test; Derp: Dermatophagoides pteronyssinus; IgE: immunoglobulin E; T0: time zero (baseline); T2: two months after the intervention. ^a One revaccinated individual not tested. ^b One control individual not tested. ^c Results are expressed as means (95% CI). ^d MW (>5 MW indicates an upper-class or class “A” consumer)³. ^e Alcohol use was defined as alcohol consumption at least once per week. ^f Marijuana use. ^g BMI (weight in kg divided by the square of the height in m). ^h BCG. ⁱ Data obtained from the ISAAC questionnaire. ^j SPT. ^k Derp whole extract. *Percentage of individuals non-reactive to Derp at baseline that became reactive 2 months after revaccination.