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Tuberculosis vaccine halves the lesion load

Posted: Sun Jul 13, 2014 9:56 am
by frodo
Source: http://www.msdiscovery.org/news/new_fin ... rogression

Cheap Vaccine Slows MS Progression
A one-time vaccination halved the rate at which early neurologic episodes progressed to diagnosable MS
JENNIE DUSHECK, M.A.
Patients with early signs of multiple sclerosis (MS) given a single injection of a cheap, safe, and common vaccine against tuberculosis (TB) were significantly less likely to develop full-blown MS than controls.

In a 5-year, double-blind clinical trial conducted by a team of researchers in Rome, patients with early signs of MS received a single dose of a vaccine against TB. Vaccinated patients showed fewer diagnostic brain lesions than did patients who received a placebo—both in the first 6 months after vaccination with no other treatment and also 5 years out with standard care. At the end of 5 years, significantly more vaccinated patients were considered symptom-free and were not being treated with disease-modifying therapy (DMT). None of the patients experienced any significant adverse events.

In the study, published December 4, 2013, in Neurology (Ristori et al.), Giovanni Ristori, M.D., Ph.D., at Sapienza University, Rome, and his team administered the TB vaccine to 33 patients and a placebo injection to another 40. For the first 6 months, participants received no other treatment but had monthly exams and MRI brain scans. After 6 months, patients were started on the standard treatment of care, interferon-b1a for 12 months, after which various DMTs were individually introduced and managed by each patient’s doctor. All the patients had follow-ups 12 months, 18 months, and 60 months after their one-time vaccination or placebo injection. They had exams every 6 months during an open-label study extension from 18 months to 60 months.

Denise Faustman, M.D., Ph.D., director of the Immunobiology Laboratory at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School in Boston, who was not involved in the study, greeted the Italian paper with enthusiasm. “This is just fantastic data,” she told MSDF. “The story should be ‘BCG, a 90-year-old vaccine with an impeccable safety record, is showing efficacy that is better than the standard of care.’ ”

The vaccine in question is the Bacillus Calmette–Guérin (BCG) vaccine, a live but weakened version of the bacterium Mycobacterium bovis. M. bovis resembles the human tuberculosis bacterium M. tuberculosis closely enough to trigger immunity to human tuberculosis (TB). BCG is one of the oldest vaccines, its development 90 years ago a direct outgrowth of Robert Koch’s Nobel Prize–winning work on TB.

BCG is cheap, safe, and the most widely used vaccine in the world. More than 4 billion people (including 80% of infants worldwide) have been vaccinated with BCG since 1921. Only a handful of countries do not vaccinate with BCG, including the United States. In the U.S., the cost of a single dose of BCG vaccine is around $3. For comparison, the cost of interferon-b1a (Biogen’s Avonex) is about $60,000 a year at Costco.

The BCG vaccine has been tested and utilized in a surprisingly long list of diseases other than TB, including bladder cancer, melanoma, and autoimmune diseases such as type 1 diabetes, Sjögren syndrome, celiac disease, and MS.