Long-term clinical efficacy and a possible mechanism of action of different modes of pneumococcal vaccination in asthma patients
https://doi.org/10.18093/0869-0189-2018-28-2-193-199
Abstract
The aim of this study was to assess long-term effects of pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) and 13-valent conjugate vaccine (PCV13) in patients with bronchial asthma. Methods. One hundred and three patients with mild to severe asthma were involved. They were randomly assigned to vaccination with PCV13, or PPV23, or PPV23 followed by PCV13, or vice versa. Clinical efficacy of vaccination was evaluated using number of asthma exacerbation a year before and 1 and 4 years after the vaccination; need in antibiotics a year before and 1 and 4 years after the vaccination; and number of hospitalizations due to asthma exacerbation a year before and 1 and 4 years after the vaccination. Results. In a year after vaccination, number of patients who had not experienced asthma exacerbation increased significantly in PPV23, PPV23/PCV13, and PCV13/PPV23 groups (р < 0.01 to p < 0.001). In 4 years after vaccination, number of patients without exacerbations increased significantly in PCV13/PPV23 group only (48.1%; р < 0.01). Number of patients who did not require hospitalization due to asthma exacerbation increased significantly in PCV13 group only (81.8%; р < 0.05). Conclusion. The authors proposed a hypothesis of impact of pneumococcal vaccines on immunopathogenesis of bronchial asthma. The authors consider vaccination against pneumococcus using PCV13 followed by PPV23 should be a part of the basic therapy of asthma.
About the Authors
A. D. Protasov
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Candidate of Medicine, Associate Professor, Department of General and Clinical Microbiology, Immunology and Allergology
Russian Federation
Candidate of Medicine, Associate Professor, Department of General and Clinical Microbiology, Immunology and Allergology
A. V. Zhestkov
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Professor, Head of Department of General and Clinical Microbiology, Immunology and Allergology
Russian Federation
Doctor of Medicine, Professor, Head of Department of General and Clinical Microbiology, Immunology and Allergology
M. P. Kostinov
I.I.Mechnikov Federal Research Institute of Vaccines and Serum, Russian Academy of Science;
I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University)
Russian Federation
Doctor of Medicine, Professor, Head of Laboratory of Preventive Vaccination And Immune Therapy of Allergic Diseases, I.I.Mechnikov Federal Research Institute of Vaccines and Serum; Professor at Department of Epidemiology, I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University)
Russian Federation
Doctor of Medicine, Professor, Head of Laboratory of Preventive Vaccination And Immune Therapy of Allergic Diseases, I.I.Mechnikov Federal Research Institute of Vaccines and Serum; Professor at Department of Epidemiology, I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University)
E. A. Korymasov
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Professor, Head of Department of Surgery, Institute of Postgraduate Medical Training; Vice-Rector for Medicine, Director of Institute of Postgraduate Medical Training
Russian Federation
Doctor of Medicine, Professor, Head of Department of Surgery, Institute of Postgraduate Medical Training; Vice-Rector for Medicine, Director of Institute of Postgraduate Medical Training
M. L. Shteyner
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Associate Professor, Department of Surgery with Course of Endoscopy, Institute of Postgraduate Medical Training
Russian Federation
Doctor of Medicine, Associate Professor, Department of Surgery with Course of Endoscopy, Institute of Postgraduate Medical Training
Yu. V. Tezikov
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Professor, Head of Department of Obstetrics and Gynecology No.1.
Russian Federation
Doctor of Medicine, Professor, Head of Department of Obstetrics and Gynecology No.1.
I. S. Lipatov
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Professor, Department of Obstetrics and Gynecology No.1
Russian Federation
Doctor of Medicine, Professor, Department of Obstetrics and Gynecology No.1
V. P. Reshetnikova
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Candidate of Medicine, Associate Professor, Department of General and Clinical Microbiology, Immunology and Allergology
Russian Federation
Candidate of Medicine, Associate Professor, Department of General and Clinical Microbiology, Immunology and Allergology
N. E. Lavrent’yeva
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation
Candidate of Medicine, Associate Professor, Department of Occupational Diseases and Clinical Phramacology
Russian Federation
Candidate of Medicine, Associate Professor, Department of Occupational Diseases and Clinical Phramacology
References
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Review
For citations:
Protasov A.D., Zhestkov A.V., Kostinov M.P., Korymasov E.A., Shteyner M.L., Tezikov Yu.V., Lipatov I.S., Reshetnikova V.P., Lavrent’yeva N.E. Long-term clinical efficacy and a possible mechanism of action of different modes of pneumococcal vaccination in asthma patients. PULMONOLOGIYA. 2018;28(2):193-199. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-2-193-199
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