title: Bacterial vaccines in chronic obstructive pulmonary disease: effects on clinical outcomes and cytokine levels.
abstract: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Exacerbation episodes impair lung function leading to disease progression. Levels of inflammation markers correlate with disease severity. Bacterial immunomodulators have shown a beneficial effect in COPD, improving symptoms and reducing the rate of exacerbations. This is an observational prospective study on 30 patients diagnosed with bronchiectasis and COPD, who received bacterial autogenous vaccine for 12 months. The rate of exacerbation, severity of symptoms and lung function were studied at baseline and after treatment. In addition, plasma levels CRP, IL6, IL8, and TNFα were measured. After treatment we found a reduction in mean acute respiratory infections and signs of lung disease. Acute phase proteins IL6 and CRP increased in blood and IL8 decreased. These changes may be related to the repeated injection of inactivated bacteria. Given the implication of these factors in the pathogenesis of COPD, particularly the production of IL8, the causes and consequences of cytokine modulation by bacterial vaccines should be investigated. Vaccination with autogenous vaccines for 1 year can produce a significant clinical improvement in COPD patients, reducing the frequency of exacerbations associated to changes in the profile of markers of inflammation.
authors.affiliation: Servicio de Neumología, Hospital Vega Baja, Orihuela, Alicante, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Ruso
authors.affiliation: R&D Department, Immunal S.A.U., Madrid, Spain.
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Marco
authors.affiliation: Sección de Neumología, Hospital de San Vicente del Raspeig, Alicante, Spain.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Martínez-Carbonell
authors.affiliation: Servicio de Neumología, Hospital Vega Baja, Orihuela, Alicante, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Carratalá
mesh_terms: D001428:Bacterial Vaccines / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D001987:Bronchiectasis / Q000276:immunology / Q000628:therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D007167:Immunotherapy; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000276:immunology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D001428:Bacterial Vaccines; D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Bacterial vaccines; COPD; immunotherapy