Bacterial immunotherapy in children with wheezing attacks: clinical impact and mechanism of action

Hall, Laura Conejero; García, Antonio Nieto; Brandi, Paola; Cid, María Nieto; Mazón, Ángel; Cueto, Francisco J.; Martínez-Cano, Sarai; Saz-Leal, Paula; Enamorado, Michel; Amores, J.; Casanovas, Miguel; Sancho, David

doi:10.1183/13993003.congress-2019.pa4998

Cited by 4 publications

(11 citation statements)

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“…Disease control CONEJERO et al [37] reported fewer overall symptoms of childhood wheezing during wheezing attacks and during the complete study ( p<0.005 for both). EMERYK et al [29] reported no significant improvement in asthma control test scores after 4, 6 and 9 months (mean 5.4 versus 5.6, p=0.69).…”

Section: Secondary End-pointsmentioning

confidence: 94%

“…Primary outcome: exacerbation frequency after bacterial lysate add-on therapy Wheezing episodes Five studies reported a significant decrease in wheezing episodes in infants after bacterial lysate use (table 1) [ 31-33, 36, 37]. Four studies reported secondary prevention after experiencing wheezing episodes [31,32,36,37]. Primary prevention of wheezing in very young infants (aged 3-9 months) with a risk for atopy was shown in a recent study [33].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Sensitivity analysis, based on the outcome definition of wheezing and reported results, revealed only two studies were eligible for a meta-analysis [36,37]. Pooled analysis resulted in an mean difference of −2.35 wheezing episodes (95% CI −3.03-−1.67, p<0.001) with low heterogeneity (I 2 =0%, p=0.65) (figure 3a).…”

Section: Study Characteristicsmentioning

confidence: 99%

Section: Secondary End-pointsmentioning

confidence: 99%

“…Time to first wheezing episode/exacerbation Time to first wheezing episode increases with bacterial lysate administration [33,37]. CONEJERO et al [37] described an increase in time to first wheezing episode, a mean number of 41 days versus 5 days with MV130 use compared to placebo (HR 0.45, 95% CI 0.30-0.67, p<0.005). SLY et al [33] described an increase in time to first wheezing episode in very young infants in favour of OM-85 (median (IQR) 442.0 (853.0-124.0) days versus 85.0 (386.0-54.0) days, p=0.006) for the placebo group.…”

Section: Secondary End-pointsmentioning

confidence: 99%

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Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis

et al. 2020

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Wheezing and asthma are a growing cause of morbidity in children and adults. Treatment is aimed at prevention of disease exacerbations and preservation of lung function. Respiratory viruses are involved in ∼40–60% of exacerbations. Bacterial lysates prevent recurrent respiratory tract infections and might reduce exacerbations. Moreover, immunomodulatory effects have been observed in human and animal studies. Here we aimed to assess the effects of bacterial lysate therapy on preschool wheezing episodes and asthma exacerbation frequency. We performed a systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and a meta-analysis using Cochrane Review Manager. Out of 2016 retrieved articles, 22 studies were included, of which five provided sufficient data for a meta-analysis.The use of bacterial lysates showed a decrease of both wheezing episodes (mean difference −2.35 (−3.03– −1.67), p<0.001) and asthma exacerbations in children (mean difference −0.90 (−1.23– −0.57), p<0.001). Additionally, antibiotic use was reduced, and the duration of wheezing episodes was also decreased. No data for adults with asthma are currently available. The immunomodulatory effect seems to be dependent on increased T-helper (Th)1-cell activation and Th2-cell suppression.These favourable effects of bacterial lysates indicate that they show promise as add-on therapy in preschool wheezing and childhood asthma.

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Section: Secondary End-pointsmentioning

confidence: 94%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Secondary End-pointsmentioning

confidence: 99%

Section: Secondary End-pointsmentioning

confidence: 99%

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Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis

et al. 2020

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ERS International Congress, Madrid, 2019: highlights from the Paediatric Assembly

et al. 2020

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Trained Immunity-Based Vaccine in B Cell Hematological Malignancies With Recurrent Infections: A New Therapeutic Approach

et al. 2021

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Infectious complications are a major cause of morbidity and mortality in B-cell hematological malignancies (HM). Prophylaxis for recurrent infections in HM patients with antibody deficiency consists of first-line antibiotics and when unsuccessful, gammaglobulin replacement therapy (IgRT). Recent knowledge of trained immunity-based vaccines (TIbV), such as the sublingual polybacterial formulation MV130, has shown a promising strategy in the management of patients with recurrent infections. We sought to determine the clinical benefit of MV130 in a cohort of HM patients with recurrent respiratory tract infections (RRTIs) who underwent immunization with MV130 for 3 months. Clinical information included the frequency of infections, antibiotic use, number of visits to the GP and hospitalizations previous and after MV130 immunotherapy. Improvement on infection rate was classified as: clear (>60% reduction of infection), partial (26%–60%) and low (≤25%) improvement. Fifteen HM patients (aged 42 to 80 years; nine females) were included in the study. All patients reduced their infection rate. Analysis of paired data revealed that the median (range, min - max) of respiratory infectious rate significantly decreased from 4.0 (8.0–3.0) to 2.0 (4.0–0.0) (p<0.001) at 12 months of MV130. A clear clinical improvement was observed in 53% (n = 8) of patients, partial improvement in 40% (n = 6) and low improvement in 7% (n = 1). These data correlated with a decrease on antibiotic consumption from 3.0 (8.0–1.0) to 1.0 (2.0–0.0) (p = 0.002) during 12 months after initiation of treatment with MV130. The number of infectious-related GP or emergency room visits declined from 4.0 (8.0–2.0) to 2.0 (3.0–0.0) (p<0.001), in parallel with a reduction in hospital admissions due to infections (p = 0.032). Regarding safety, no adverse events were observed. On the other hand, immunological assessment of serum IgA and IgG levels demonstrated an increase in specific antibodies to MV130-contained bacteria following MV130 immunotherapy. In conclusion, MV130 may add clinical benefit reducing the rate of infections and enhancing humoral immune responses in these vulnerable patients.

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Bacterial immunotherapy in children with wheezing attacks: clinical impact and mechanism of action

Cited by 4 publications

References 0 publications

Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis

Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis

ERS International Congress, Madrid, 2019: highlights from the Paediatric Assembly

Trained Immunity-Based Vaccine in B Cell Hematological Malignancies With Recurrent Infections: A New Therapeutic Approach

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