El-Zein, Mariam; Parent, Marie-Élise 
ORCID: https://orcid.org/0000-0002-4196-3773; Benedetti, Andrea et Rousseau, Marie-Claude ORCID: https://orcid.org/0000-0001-5215-8086
(2010).
Does BCG vaccination protect against the development of childhood asthma? A systematic review and meta-analysis of epidemiological studies
International Journal of Epidemiology
, vol. 39
, nº 2.
pp. 469-486.
DOI: 10.1093/ije/dyp307.
Résumé
BACKGROUND: Results have been conflicting as to whether Bacillus Calmette-Guerin (BCG) vaccine, a non-specific stimulator of the immune function, protects, predisposes or is unrelated to the development of childhood asthma. In this systematic review and meta-analysis, we qualitatively and quantitatively appraised the epidemiological evidence.
METHODS: Eligible studies were identified using a search strategy that included a computerized literature search and a manual search of each article's reference list, up to June 2008. A total of 23 studies were included (10 cohort, 5 case-control and 8 cross-sectional). Each study was summarized and rated for methodological quality. Pooled odds ratio (OR) estimates and 95% confidence intervals (CIs) were calculated using fixed-effects (FE) or random-effects (RE) models; if heterogeneity was present, the latter was used. Three indicators of BCG exposure were considered including BCG vaccination, tuberculin response and scar diameter.
RESULTS: The pooled estimate of association for 23 studies reporting on any of the three indicators suggested a protective effect of BCG exposure on childhood asthma occurrence. The studies were heterogeneous, especially when tuberculin response was considered. Restriction to a subgroup of 16 studies that considered BCG vaccination indicated a protective effect with no evidence of heterogeneity. The overall pooled OR using an FE model was 0.86 (95% CI 0.79-0.93). Exclusion of three studies with the lowest quality scores showed a similar association.
CONCLUSION: These results strengthen the epidemiological evidence in support of the hypothesis that exposure to the BCG vaccine in early life prevents asthma, possibly through a modulation of the immune maturation process.
| Type de document: | Article |
|---|---|
| Mots-clés libres: | Asthma; BCG vaccine; child; meta-analysis; review; tuberculin |
| Centre: | Centre INRS-Institut Armand Frappier |
| Date de dépôt: | 30 juin 2024 17:52 |
| Dernière modification: | 30 juin 2024 17:52 |
| URI: | https://espace.inrs.ca/id/eprint/14645 |
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