Significance of Bacillus Calmette-Guerin (BCG) vaccine intervention for patients with Type 1 Diabetes (T1D): A systematic review and meta-analysis

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM Diabetes & Metabolic Syndrome-Clinical Research & Reviews Pub Date : 2024-08-01 DOI:10.1016/j.dsx.2024.103102
Sunil B. Korde , Smita R. Pillewan , Sanket R. Dumbre , Anjali R. Bandgar , Prajakta S. Shinde , Sunil Gairola , Vandana S. Nikam
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Abstract

Purpose

Immunotherapy is an emerging therapeutic modality for many autoimmune, oncology, and infectious diseases to cure or prevent the underlying causes. Several immunotherapeutic agents are investigated for their beneficial potential in patients with diabetes. However, none have culminated into a successful therapy. The present comprehensive meta-analysis and systematic review covers the last two decades of historical research evaluating the Bacillus Calmette-Guerin (BCG) vaccine as an immunotherapeutic agent in diabetes, along with updated information on similar recent publications.

Method

A total of 278 articles were retrieved through literature databases, and after applying inclusion and exclusion criteria as per PRISMA guidelines, seven studies were selected for meta-analysis using Cochrane Q statistics.

Results

Our meta-analysis revealed marginal benefits, lowering glycosylated/glycated haemoglobin (HbA1C) levels and glutamic-acid-decarboxylase (GAD) autoantibodies in BCG treated people with Type 1 Diabetes (T1D) compared to the matched control individuals. The BCG intervention found to be ineffective in regulating C-peptide (connecting peptide) and clinical remission (CR) i.e. improved glycemic regulation, though beneficial tendency was observed.

Conclusion

Our systematic review and meta-analysis revealed benefits of BCG vaccine intervention in T1D patients, including improved HbA1C and GAD autoantibody levels. However, the study has several limitations stemming from BCG vaccine-related factors and patient characteristics. Therefore, a large clinical trial with an enhanced study design is needed to validate the immunity-related benefits of the BCG vaccine for glucose metabolism in patients with T1D.

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卡介苗(BCG)干预对 1 型糖尿病(T1D)患者的意义:系统回顾与荟萃分析。
目的:免疫疗法是一种新兴的治疗方式,可用于治疗或预防许多自身免疫性疾病、肿瘤和传染性疾病的根本原因。目前正在研究几种免疫治疗药物对糖尿病患者的益处。然而,目前还没有一种疗法取得成功。本综合荟萃分析和系统综述涵盖了过去二十年中对卡介苗(BCG)作为糖尿病免疫治疗药物进行评估的历史研究,以及近期类似出版物的最新信息:方法:通过文献数据库共检索到 278 篇文章,在按照 PRISMA 指南应用纳入和排除标准后,利用 Cochrane Q 统计法选择了 7 项研究进行荟萃分析:我们的荟萃分析显示,与匹配的对照组相比,接受卡介苗治疗的 1 型糖尿病(T1D)患者在降低糖基化/糖化血红蛋白(HbA1C)水平和谷氨酸脱羧酶(GAD)自身抗体方面略有获益。卡介苗干预对调节C肽(连接肽)和临床缓解(CR)(即改善血糖调节)无效,但也观察到有益的趋势:我们的系统综述和荟萃分析揭示了卡介苗干预对 T1D 患者的益处,包括改善 HbA1C 和 GAD 自身抗体水平。然而,由于卡介苗相关因素和患者特征的影响,这项研究还存在一些局限性。因此,需要一项研究设计更完善的大型临床试验来验证卡介苗对 T1D 患者糖代谢的免疫相关益处。
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来源期刊
CiteScore
22.90
自引率
2.00%
发文量
248
审稿时长
51 days
期刊介绍: Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care. Types of Publications: Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.
期刊最新文献
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