Does immunotherapy with heat-killed Mycobacterium vaccae offer hope for the treatment of multi-drug-resistant pulmonary tuberculosis?

Stanford, J. L. and Stanford, C. A. and Grange, J. M. and Lan, N. N. and Etemadi, A. (2001) Does immunotherapy with heat-killed Mycobacterium vaccae offer hope for the treatment of multi-drug-resistant pulmonary tuberculosis? Respiratory Medicine, 95 (6). pp. 444-447.

[img] Text
Does immunotherapy with heat-killed Mycobacterium vaccae offer hope for the treatment of multi-drug-resistant pulmonary tuberculosis.pdf

Download (300kB)
[img] Text
S0954611101910650

Download (61kB)

Abstract

The ability of immunotherapy with heat-killed Mycobacterium vaccae (NCTC 11659), as an addition to the available chemotherapy, to improve the outcome in patients with multi-drug-resistant tubercle bacilli (MDRTB) who had not been cured by chemotherapy alone was evaluated in tuberculosis centres in Estonia, Iran, Kuwait, New Zealand, Romania, Vietnam and the U.K. A total of 337 patients in the above countries received intradermal injections of M. vaccae in addition to chemotherapy. Patients were grouped according to the length of their histories of disease: less than or greater than 2 years duration. Initially, single doses of M. vaccae were given but subsequently up to 12 doses at 2-month intervals were given. Chemotherapy varied from isoniazid alone to drugs selected according to susceptibility tests. Most patients had failed to respond to repeated courses of chemotherapy and the majority were expected to die from their disease. Results were assessed by sputum smear and culture and by clinical observations. Cured patients were followed for 18-24 months to exclude relapse. Eighteen of 22 (82) patients with disease for less than 2 years were bacteriologically cured by one or two doses of M. vaccae. Among 315 chronic patients, 24 (7.6) were cured after one dose, 37.9 after seven doses and 41.6 after 12 doses. Sixty-six chronic patients were lost to follow-up, or died, during the multi-dose regimens. Nine of 33 patients (27) with advanced disease unaffected by several courses of chemotherapy and discharged on isoniazid alone in Vietnam were cured by 3-12 injections of M. vaccae. The data provide preliminary evidence that the addition of immunotherapy with M. vaccae to chemotherapy improves the rate of cure of MDRTB, most effectively in patients with short histories of disease, but multiple dosing can have beneficial effects in chronic patients in whom chemotherapy has failed. A randomized clinical trial of this immunotherapy in MDRTB patients is therefore required. © 2001 Harcourt Publishers Ltd.

Item Type: Article
Additional Information: Cited By :26 Export Date: 16 February 2020 CODEN: RMEDE Correspondence Address: Stanford, J.L.; Department of Medical Microbiology, Windeyer Institute Medical Sciences, Royal Free/Univ. College Med. School, 46 Cleveland Street, London W1T 4JF, United Kingdom; email: j.stanford@ucl.ac.uk
Uncontrolled Keywords: Immunotherapy Multi-drug resistance Mycobacterium vaccae Tuberculosis isoniazid Mycobacterium vaccine tuberculostatic agent antibiotic resistance antibiotic sensitivity article chronicity clinical observation clinical trial controlled clinical trial controlled study disease duration drug efficacy Estonia evaluation follow up health center heat human Iran Kuwait lung tuberculosis major clinical study mortality Mycobacterium tuberculosis New Zealand priority journal randomized controlled trial relapse Romania sputum culture sputum smear treatment outcome United Kingdom Viet Nam
Subjects: WF Respiratory System
QW Microbiology and Immunology
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib7 lib7
Date Deposited: 23 Apr 2020 09:38
Last Modified: 23 Apr 2020 09:38
URI: http://eprints.mums.ac.ir/id/eprint/17128

Actions (login required)

View Item View Item