Non-specific effects of BCG vaccine on viral infections

Moorlag, S.J.C.F.M.; Arts, R.J.W.; van Crevel, R.; Netea, M.G.

doi:10.1016/j.cmi.2019.04.020

Cited by 479Immune responses and vaccinationsTuberculosis Research and EpidemiologyImmunotherapy and Immune Responses

Non-specific effects of BCG vaccine on viral infections

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Moorlag, S.J.C.F.M., Arts, R.J.W., van Crevel, R., Netea, M.G.·2019·Clinical Microbiology and Infection

DOI 10.1016/j.cmi.2019.04.020

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Abstract

Background Some strains of Bacillus Calmette-Guérin (BCG) vaccine not only confer protection against disseminated forms of tuberculosis, but also reduce all-cause mortality by the induction of protection against infections with non-related pathogens.Objectives We review evidence for non-specific protection induced by BCG vaccination against viral infections, discuss possible mechanisms of action, and summarize implications for vaccination policies and vaccine discovery.Sources Relevant studies retrieved from PubMed and clinicaltrials.gov.Content Numerous epidemiological, clinical and immunological studies demonstrate that BCG vaccination impacts the immune response to subsequent infections, resulting in reduced morbidity and mortality. Important lines of evidence indicating that BCG protects against viral pathogens comes from experimental studies in mice showing that BCG offers protection against various DNA and RNA viruses, including herpes and influenza viruses. Recently, the effect of BCG on an experimental viral infection in humans has been demonstrated. These effects are thought to be mediated via the induction of innate immune memory and heterologous lymphocyte activation, resulting in enhanced cytokine production, macrophage activity, T-cell responses and antibody titres.Implications The discovery of innate immune memory has greatly improved our understanding of the mechanisms underlying the non-specific effects induced by BCG vaccination. However, a full understanding of the molecular mechanisms that underlie this phenomenon is still evolving. By identifying the factors that impact the non-specific effects of BCG, we will take an important step towards novel therapeutic options and vaccination strategies, which might lead to a reduction in severe morbidity and mortality associated with viral infections.

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The BCG vaccine provides immunity benefits against respiratory infections.
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Authors: Moorlag, S. J. C. F. M., Arts, R. J. W., van Crevel, R., & Netea, M. G.
Affiliations: Radboud University Medical Center (NL)
University of Bonn (DE)
Corresponding author: Moorlag, S.J.C.F.M.
ORCID: Moorlag, S.J.C.F.M.
Arts, R.J.W.
Netea, M.G.
Venue: Clinical Microbiology and Infection
Publisher: Elsevier BV
Published: 2019-12
Volume: 25
Issue: 12
Pages: 1473-1478
ISSN: 1198-743X (ISSN-L)
DOI: 10.1016/j.cmi.2019.04.020
OpenAlex: W2943762716
Cited by: 479
References: 55
Citations by year: 2026: 20 · 2025: 34 · 2024: 35 · 2023: 58 · 2022: 75 · 2021: 102 · 2020: 152 · 2019: 3
FWCI: 7.16
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 366 d)
Locations: Clinical Microbiology and Infection (publishedVersion)
PubMed (publishedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Funders: Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Topics: Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
Keywords: BCG vaccine, non-specific vaccine effects, viral infection, heterologous immunity, trained immunity, herpesvirus, influenza virus, DNA viruses, RNA viruses, macrophage activation, T cell response, cytokine production, vaccination policy
MeSH terms: Animals, BCG Vaccine, Humans, Immunity, Innate, Immunologic Memory, Lymphocyte Activation, Virus Diseases, Cross Protection, Disease Resistance, Immunity, Heterologous

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Non-specific effects of BCG vaccine on viral infections

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