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Vacinação contra a tuberculose : será o fim do BCG na Europa?
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A OMS estimou 340.000 novos casos de Tuberculose no continente europeu em 2014. A diminuição da incidência ao longo das ultimas décadas levou à mudança do paradigma vacinal, sendo que, atualmente, grande parte dos países europeus apenas faz vacinação dos grupos de risco em detrimento da vacinação universal. No ano de 2016, Portugal passou a fazer dessa lista, contudo, os grandes centros urbanos do país continuam a ter incidências consideráveis da doença.
O Bacilo Calmette-Guérin (BCG) é a única vacina que reduz o risco de formas graves de tuberculose na infância, impedindo a sua disseminação, contudo a sua eficácia contra as formas pulmonares nos adultos é variável. As diferentes estirpes vacinais produzidas por vários laboratórios não são homogéneas nas suas caraterísticas genéticas, colocando em dúvida se mantêm a mesma imunogenicidade. A insuficiência na prevenção das formas pulmonares produziu o mote para a investigação de novas vacinas, existindo 13 candidatos em estudo.
O Mycobacterium tuberculosis (Mtb) evoluiu com a espécie humana, obtendo numerosas alterações genéticas que permitem evasão ao reconhecimento celular e subsequente destruição pelo hospedeiro. A investigação destes mecanismos é essencial para a produção de novas vacinas ou adjuvantes do BCG.
WHO has estimated 340,000 new cases of tuberculosis on the European continent by 2014. The decline in incidence, in the last decades, led to a change in the vaccine paradigm, with most European countries only vaccinating at-risk groups. In the year 2016, Portugal join this list, however, the great urban centers continue to have considerable incidence of the disease. Bacille Calmette-Guérin (BCG) is the only vaccine that reduces the risk of severe forms of tuberculosis in childhood, preventing its spread, but its efficacy against pulmonary forms in adults is variable. The different vaccine strains produced by several laboratories are not homogeneous in their genetic characteristics, casting doubt on whether they maintain the same immunogenicity. Failure to prevent pulmonary forms produced the motive for the investigation of new vaccines, with 13 candidates under study. Mycobacterium tuberculosis (Mtb) evolved with the human species, obtaining numerous genetic alterations that allow evasion to the cellular recognition and subsequent destruction by the host. Research into these mechanisms is essential to produce new BCG vaccines or adjuvants.
WHO has estimated 340,000 new cases of tuberculosis on the European continent by 2014. The decline in incidence, in the last decades, led to a change in the vaccine paradigm, with most European countries only vaccinating at-risk groups. In the year 2016, Portugal join this list, however, the great urban centers continue to have considerable incidence of the disease. Bacille Calmette-Guérin (BCG) is the only vaccine that reduces the risk of severe forms of tuberculosis in childhood, preventing its spread, but its efficacy against pulmonary forms in adults is variable. The different vaccine strains produced by several laboratories are not homogeneous in their genetic characteristics, casting doubt on whether they maintain the same immunogenicity. Failure to prevent pulmonary forms produced the motive for the investigation of new vaccines, with 13 candidates under study. Mycobacterium tuberculosis (Mtb) evolved with the human species, obtaining numerous genetic alterations that allow evasion to the cellular recognition and subsequent destruction by the host. Research into these mechanisms is essential to produce new BCG vaccines or adjuvants.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
BCG Eficácia vacinal Mycobacterium tuberculosis Estirpes vacinais Nova vacinação Doenças transmissíveis