Whither Mycobacterium vaccae—encore

• Published in: The Lancet (British edition) 2002-10, Vol.360 (9339), p.1032-1033
• Main Authors: Fourie, P Bernard, Ellner, Jerrold J, Johnson, John L
• Format: Article
• Language: English
• Subjects: AIDS-Related Opportunistic Infections - drug therapy; AIDS-Related Opportunistic Infections - mortality; Animals; Bacteria; Bacterial Vaccines - immunology; Bacterial Vaccines - therapeutic use; Chemotherapy; Design; Disease Models, Animal; Gangrene; Humans; Immunology; Immunotherapy; Immunotherapy - methods; Mice; Mortality; Mycobacterium; Research Design - standards; Sputum - microbiology; Survival Analysis; Treatment Outcome; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - immunology; Tuberculosis - microbiology; Tuberculosis - mortality; Vaccines
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(02)11173-1

In the recently held 4th World Congress on TB, [Wu XQ] and colleagues6 presented data from animal and human studies in which multiple doses of M vaccae were used. Lung lesions were not observed in the mice treated with M vaccae at month 5 after immunotherapy. 77 newly diagnosed patients on commonly used rifampicin-based short-course chemotherapy were randomised to receive saline placebo or M vaccae three times every 2 weeks after start of drug therapy. Sputum conversion after a month of tuberculosis treatment occurred more frequently among patients receiving M vaccae but was similar at later months to controls. A similar observation was made in an earlier study in Uganda with a single injection of M vaccae,7 and Mwinga and colleagues mention the possibility that the 2-month sputum conversion data in their study might indicate that an early effect of sputum conversion may have been missed (1-month sputums were not collected). Increased sputum conversion at 1 month in the Uganda study was associated with greater improvement in chest radiographs at the end of chemotherapy. Further, M vaccae administration was not associated with modulation of the production of cytokines, including interferon-y and tumour necrosis factor-et.