BCG vaccination in humans inhibits systemic inflammation in a sex-dependent manner
Valerie A.C.M. Koeken, … , Reinout van Crevel, Mihai G. Netea
Valerie A.C.M. Koeken, … , Reinout van Crevel, Mihai G. Netea
Published July 21, 2020
Citation Information: J Clin Invest. 2020;130(10):5591-5602. https://doi.org/10.1172/JCI133935.
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Clinical Medicine Immunology Vaccines

BCG vaccination in humans inhibits systemic inflammation in a sex-dependent manner

Abstract

BACKGROUND Induction of innate immune memory, also termed trained immunity, by the antituberculosis vaccine bacillus Calmette-Guérin (BCG) contributes to protection against heterologous infections. However, the overall impact of BCG vaccination on the inflammatory status of an individual is not known; while induction of trained immunity may suggest increased inflammation, BCG vaccination has been epidemiologically associated with a reduced incidence of inflammatory and allergic diseases.METHODS We investigated the impact of BCG (BCG-Bulgaria, InterVax) vaccination on systemic inflammation in a cohort of 303 healthy volunteers, as well as the effect of the inflammatory status on the response to vaccination. A targeted proteome platform was used to measure circulating inflammatory proteins before and after BCG vaccination, while ex vivo Mycobacterium tuberculosis– and Staphylococcus aureus–induced cytokine responses in peripheral blood mononuclear cells were used to assess trained immunity.RESULTS While BCG vaccination enhanced cytokine responses to restimulation, it reduced systemic inflammation. This effect was validated in 3 smaller cohorts, and was much stronger in men than in women. In addition, baseline circulating inflammatory markers were associated with ex vivo cytokine responses (trained immunity) after BCG vaccination.CONCLUSION The capacity of BCG to enhance microbial responsiveness while dampening systemic inflammation should be further explored for potential therapeutic applications.FUNDING Netherlands Organization for Scientific Research, European Research Council, and the Danish National Research Foundation.

Authors

Valerie A.C.M. Koeken, L. Charlotte J. de Bree, Vera P. Mourits, Simone J.C.F.M. Moorlag, Jona Walk, Branko Cirovic, Rob J.W. Arts, Martin Jaeger, Helga Dijkstra, Heidi Lemmers, Leo A.B. Joosten, Christine S. Benn, Reinout van Crevel, Mihai G. Netea

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Figure 2

Correlations between baseline inflammatory markers and baseline whole blood counts.

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Correlations between baseline inflammatory markers and baseline whole bl...
(A) Spearman’s correlations between absolute whole blood counts (monocytes, total white blood cells, neutrophils, lymphocytes, eosinophils, basophils, platelets, red blood cells, and hemoglobin) and circulating inflammatory markers at baseline (before BCG vaccination). Positive correlations are depicted in red, negative correlations in blue (n = 302). Spearman’s correlations between whole blood neutrophil counts and circulating oncostatin M (OSM) (B), and between whole blood monocyte counts and circulating IL-6 (C) are shown as examples of positive correlations (n = 300).