The BCG vaccine used in some countries for the prevention of tuberculosis, when introduced at the early stage of multiple sclerosis (MS), slows the development of the disease - these preliminary data were obtained during a study in long-term, the results of which were published in the December online version of Neurology.

It has been found that the introduction of BCG vaccine in patients with clinically isolated syndrome (CIS) leads to the appearance of fewer lesions typical of MS and to a lower probability of developing MS clinically defined in the 5 years following the follow-up period.

Dr. Giovanni Ristori (University of Rome, Italy) noted that a pilot study conducted in the 1990s. Of the last century, it was shown that in patients with multiple sclerosis who received the BCG vaccine, there was a decrease in the degree of disease activity according to MRI. According to the researchers, since the vaccine is safe, an interesting idea is to use it at the earliest stage of MS - in patients with clinically isolated syndrome. The effect of the vaccine was very significant - a decrease in the number of lesions on MRI (on average, 3 in the study group and 7 in unvaccinated individuals). In addition, 58% of patients who received the BCG vaccine did not relapse into MS within 5 years of the follow-up period, compared to 30% in the control group.

Despite the fact that the results of this study should be considered preliminary and on the basis of which it is premature to give clinical recommendations, other large-scale projects to study this interesting effect are requested.

The authors note that the mechanism of the prophylactic effect of the BCG vaccine in MS remains uncertain, however, the relationship between automomunity and infectious diseases is very likely. The basic idea is that infections can increase the risk of developing MS, but a minimal "mild" microbial load can have a protective effect. One of the most common theories says that the reason for the increase in the frequency of autoimmune diseases and allergic problems in recent years is that the use of antibiotics and cleaner environmental conditions lead to a decrease of the effect of microbes on our bodies in very early childhood. The introduction of the vaccine promotes a slight effect of microbes, causing an immunological reaction without dangerous signals.

Currently, there is also experience with the use of the BCG vaccine in patients with type I diabetes mellitus, who have significantly improved the course of the disease over a long period of follow-up.

In this study, 82 patients with the first demyelinating episode and the presence of lesions characteristic of MS on MRI were randomized to receive the BCG vaccine or the placebo. The patients were followed up monthly and underwent regular MRI exams. Both groups received interferon β-1a v / m for 12 months. After a month of 18 years, the patients were given drugs that alter the course of the disease, which the neurologist considered showed in a long, open phase of the study, which lasted up to 60 months.

Out of 82 patients included, 73 completed the study - 33 in the vaccine group and 40 in the placebo group. During the initial 6-month period, the number of cumulative lesions was lower in patients who received the BCG vaccine.

Clinical results indicate that after 5 years of observation, the cumulative probability of developing clinically defined MS was lower in the vaccinated group, and many patients who received the BCG vaccine did not need to use drugs that modify the course of the disease.

Researchers warn clinicians against the off-label use of BCG vaccine to treat patients with clinically isolated syndrome or multiple sclerosis (that is, without official guidance), because the effectiveness of the The vaccine and the safety of its reintroduction are still unknown. This study provides evidence of the effectiveness of BCG in preventing the progression of multiple sclerosis, however, the sample size was small and the controlled portion of the study was relatively short. In connection with the above, large-scale studies are extremely popular to confirm the efficacy and acceptable safety of the BCG vaccine in multiple sclerosis.