Scoping Review: Efektivitas Pemberian Vaksin Booster Bacille Calmette Guerin (BCG) atau Rekombinannya pada Peningkatan Sistem Imun terhadap Mycobacterium Tuberculosis

Fadhilah Marwarni, Ami Rachmi, Lelly Yuniarti

Abstract


Abstract. Tuberculosis is a infectious disease caused by Mycobacterium tuberculosis. This disease attacks the lungs (pulmonary tuberculosis) and can affect other parts of the body (extrapulmonary tuberculosis). The BCG vaccine can prevent the incidence of severe TB in children and the risk of death. The effectiveness of the BCG vaccine decreases with time and cannot protect adults from pulmonary TB so a BCG booster vaccine using recombinant vaccine is needed. This scoping review aims to explore and analyze systematically articles related to the effectiveness of administering revaccines or BCG booster vaccines or their recombinants in increasing immunity against Mycobacterium tuberculosis. This research is a Scoping Review, by searching for articles from  PubMed, Springer Link, and Science Direct databases. There were 280 articles that matched the inclusion criteria and 275 articles that were included in the exclusion criteria. The PICOS criteria in this study were Population (people who had been given BCG vaccine), Intervention (vaccine booster BCG or its recombinant), Comparison (people who were not given thevaccine booster), Outcome (immunity to Mycobacterium tuberculosis), Study (Randomized Control Trial). This research was conducted in the period November-December 2020. The articles that reviewed were five articles. The analysis showed vaccine a booster in the form of a recombinant vaccine and a recombinant vaccine together with an adjuvant shown to be safe, well tolerated and immunogenic thus considered protective against M. tuberculosis. The conclusion: the administration of the Bacile Calmette Guerin (BCG) booster vaccine or its recombinant is effective in increasing the immune system against Mycobacterium Tuberculosis, the types of recombinant vaccines that are effective are MVA85A, AERAS-402, H4: IC31, H56: IC31.

Keywords: BCG vaccine, BCG vaccine booster, efficacy tuberculosis

Abstrak. Tuberkulosis adalah penyakit menular yang disebabkan oleh Mycobacterium tuberculosis. Penyakit ini menyerang paru (tuberkulosis paru) dan dapat menyerang bagian tubuh lain (tuberkulosis ekstrapulmonal). Vaksin BCG dapat mencegah kejadian TB yang berat pada anak dan risiko kematian. Efektivitas vaksin BCG menurun bersamaan dengan waktu dan tidak dapat memproteksi orang dewasa dari TB paru sehingga dibutuhkan vaksin booster BCG menggunakan vaksin rekombinan. Scoping review ini bertujuan mengeksplorasi dan menganalisis secara sistematis artikel yang terkait dengan efektivitas pemberian revaksin atau vaksin booster BCG atau rekombinannya pada peningkatan imunitas terhadap Mycobacterium tuberculosis. Penelitian ini merupakan Scoping Review dengan mencari artikel dari database PubMed, Springer Link, dan Science Direct. Artikel yang sesuai dengan kriteria inklusi sebanyak 280 artikel dan yang termasuk dalam kriteria eksklusi sebanyak 275 artikel. Kriteria PICOS dalam penelitian ini adalah Population (orang yang sudah diberikan vaksin BCG), Intervention (pemberian vaksin booster BCG atau rekombinannya), Comparison (orang yang tidak diberikan vaksin booster), Outcome (imunitas terhadap Mycobacterium tuberculosis), Study (Randomized Control Trial). Penelitian ini dilakukan pada periode November-Desember 2020. Artikel yang di-review sebanyak lima artikel. Hasil analisis menunjukkan vaksin booster berupa vaksin rekombinan maupun vaksin rekombinan bersama adjuvan terbukti aman, dapat ditoleransi dengan baik, dan bersifat imunogenik sehingga dianggap protektif terhadap M. tuberculosis. Kesimpulan: pemberian vaksin booster Bacile Calmette Guerin (BCG) atau  rekombinannya efektif dalam meningkatkan sistem imun terhadap Mycobacterium tuberculosis, jenis vaksin rekombinan yang efektif adalah MVA85A, AERAS-402, H4:IC31, H56:IC31.

Kata kunci: BCG vaksin, BCG vaksin booster, efikasi tuberkulosis


Keywords


BCG vaksin, BCG vaksin booster, efikasi tuberkulosis

Full Text:

PDF

References


World Health Organization. Are updated every year for the tuberculosis. Geneva. 2020;50:232. (diunduh 5 Januari 2019). Tersedia dari: https://www.who.int/tb/publications/global_report/en/

WHO. Global tuberculois report - Executive summary. Switzerland. WHO. 2015;7(1):126.

Muthiah A, Indraswari N, Sujatmiko B. Karakteristik pasien tuberkulosis lost to follow up dari Empat RS di Kota Bandung. Epidemiolog Kesehat Indones. 2019;3(1):25–34.

Kementrian Kesehatan RI. Program pengendalian tuberkulosis. Jakarta: Kemenkes RI; 2017.

WHO, SAGE working group on BSG vaccines. Report on BCG vaccine use for protection against mycobacterial infections including tuberculosis, leprosy, and other non tuberculous mycobacteria infections. Vaccine. 2017:1– 77.

Pediatri S. Jadwal imunisasi rekomendasi IDAI. Sari Pediatr. 2016;2(1):43.

Li J, Zhao A, Tang J, Wang G, Shi Y, Zhan L, dkk. Tuberculosis vaccine development: from classic to clinical candidates. Eur J Clin Microbiol Infect Dis. 2020;39(8):1405–25.

McShane H. Tuberculosis vaccines: beyond bacilli calmette-guérin. Philos Trans R Soc B Biol Sci. 2011;366(1579):2782–9.

Martin C, Aguilo N, Marinova D, Gonzalo-Asensio J. Update on TB vaccine pipeline. Appl Sci. 2020;10(7):1–15.

Kagina BMN, Tameris MD, Geldenhuys H, Hatherill M, Abel B, Hussey GD, dkk. The novel tuberculosis vaccine, AERAS-402, is safe in healthy infants previously vaccinated with BCG, and induces dose-dependent CD4 and CD8T cell responses. Vaccine. 2014;32(45):5908–17.

Ota MOC, Odutola AA, Owiafe PK, Donkor S, Owolabi OA, Brittain NJ, dkk. Immunogenicity of the tuberculosis vaccine MVA85A is reduced by coadministration with EPI vaccines in a randomized controlled trial in Gambian infants. Sci Transl Med. 2011;3(88):1–7.

Tameris M, Hokey DA, Nduba V, Sacarlal J, Laher F, Kiringa G, dkk. A double-blind, randomised, placebo-controlled, dose-finding trial of the novel tuberculosis vaccine AERAS-402, an adenovirus-vectored fusion protein, in healthy, BCG-vaccinated infants. 2015;33(25):2944–54. (diunduh 20 November 2020). Tersedia dari: http://dx.doi.org/10.1016/j.vaccine. 2015.03.070

Norrby M, Vesikari T, Lindqvist L, Maeurer M, Ahmed R, Mahdavifar S, dkk. Safety and immunogenicity of the novel H4:IC31 tuberculosis vaccine candidate in BCG-vaccinated adults: Two phase I dose escalation trials. 2017;35(12):1652–61. (diunduh 1 Desember 2020). Tersedia dari: Bekker http://dx.doi.org/10.1016/j.vaccine. 2017.01.055

LG, Dintwe O, Fiore-Gartland A, Middelkoop K, Hutter J, Williams A, dkk. Tuberculosis vaccines: A phase 1b randomized study of the safety and immunological responses to vaccination with H4:IC31, H56:IC31, and BCG revaccination in Mycobacterium tuberculosis-uninfected adolescents in Cape Town, South Africa. 2020;21:1–11.

Dalmia N, Ramsay AJ. Prime–boost approaches to tuberculosis vaccine development. Expert Rev Vaccines. 2012;11(10):1221–33.

Abubakar I, Pimpin L, Ariti C, Beynon R, Mangtani P, Sterne J, dkk. Systematic review and meta-analysis of the current evidence on the duration of protection by bacillus Calmette-Guérin vaccination against tuberculosis. Health Technol Assess (Rockv). 2013;17(37):1–4.

Trial D, Suliman S, Kany A, Luabeya K, Geldenhuys H, Tameris M, dkk. New Vaccines: Dose optimization of H56: IC31 vaccine for TB endemic populations : a double-blind, placebo-running. 2018;3(66):1–62.

Nemes E, Geldenhuys H, Rozot V, Rutkowski KT, Ratangee F, Bilek N, dkk. Prevention of M. tuberculosis Infection with H4:IC31 Vaccine or BCG Revaccination . N Engl J Med. 2018;379(2):138–49.

Beveridge NER, Price DA, Casazza JP, Pathan AA, Sander CR, Asher TE, dkk. Immunisation with BCG and recombinant MVA85A induces long-lasting, polyfunctional Mycobacterium tuberculosis-specific CD4 + memory T lymphocyte populations. Eur J Immunol. 2017;37(11):3089–100.




DOI: http://dx.doi.org/10.29313/kedokteran.v7i1.26748

Flag Counter    Â