Genetic and immunologic determinants of BCG disease: from mechanism to prevention - PubMed
8 hours ago
- #vaccination strategies
- #BCG disease
- #drug resistance
- BCG disease results from a combination of host immune deficiencies (70% involving IFN-γ/IL-12 pathway defects) and BCG strain genetic mutations (e.g., pks12, mma3).
- BCG strains show reduced virulence compared to Mtb due to RD1 region loss but exhibit strain heterogeneity affecting cell wall lipid metabolism and systemic symptoms.
- Some BCG strains display low-level resistance to isoniazid and rifampicin, linked to mma3 and pncA mutations.
- Prevention strategies include genetic modifications of BCG strains (e.g., BCGΔBCG1419c), delayed vaccination, and immune monitoring (TREC/KREC screening).
- BCG disease exemplifies host-pathogen interaction imbalance, requiring integrated molecular and clinical approaches for control.