Immunization with bacillus Calmette-Guerin vaccine increases aortic atherosclerosis in the cholesterol-fed rabbit

New Zealand White rabbits were injected subcutaneously with either a human dose of bacillus Calmette Guerin (BCG) vaccine (n = 7) or saline (n = 7). A further half dose of BCG or saline was injected after a further 4 weeks. The animals were subsequently fed a 0.25-1% cholesterol diet for 10 weeks, 8 weeks after the first injection. The rabbits were killed and perfusion fixed with 4% paraformaldehyde. The integrated plasma cholesterol levels did not differ significantly between the groups (P > 0.05). Plasma levels of anti-mycobacterial antibodies rose following BCG immunization, reaching a peak after 8 weeks (P < 0.05) compared to basal titers and the control group. BCG immunization was also associated with increased peripheral lymphocyte and monocyte activation, as evidenced by increased surface expression of IL-2 receptor (CD25) (P < 0.02) and MAC-I (CD11b) (P < 0.05), respectively. Significantly more mononuclear cells bound to the aortic endothelium of BCG immunized, cholesterol-fed rabbits (1.93+/-0.77 mononuclear cells/1000 endothelial cells) than to that of saline immunized rabbits (0.08+/-0.08 mononuclear cells/1000 endothelial cells; P < 0.01). The aortic intimal:medial ratio was greater in the BCG immunized rabbits (0.19+/-0.08) than those treated with saline (0.04+/-0.03; P < 0.05). This suggests that BCG immunization enhances peripheral leucocyte activation, aortic monocyte recruitment and atherogenesis in the cholesterol-fed rabbit.     

Unconventional vaccine targets. Immunization for pregnancy, peptic ulcer, gastric cancer, cocaine abuse, and atherosclerosis

Vaccine technology can be applied to targets of intervention that currently have not been considered preventable by immunization. Targets include some diseases caused by, or related to, infectious agents, and other conditions clearly unassociated with disease pathogens. This article considers vaccines for pregnancy, peptic ulcer disease, gastric cancer, cocaine abuse and atherosclerosis.     

Immunization for the elderly

The morbidity and mortality of vaccine-preventable diseases among older adults are high. Despite the benefits of elderly vaccination, vaccination rates remain low and especially among some minority groups. Specific strategies for improving the rate of vaccination have been developed for medical offices and clinics, hospitals, and other health care institutions. There are vaccines that are recommended routinely for the elderly while other vaccines are recommended in certain circumstances. Knowing the indications, contraindications, and adverse reactions to the recommended vaccines for the elderly is very important to the primary care physicians.     

Immunization for hospital staff

PURPOSE OF REVIEW: In this review the recent literature on the topic of immunization of healthcare workers is assessed. The emphasis lies on immunizations that are directly related to the risks of healthcare workers in the workplace. RECENT FINDINGS: Acceptance of influenza immunization by healthcare workers remains too low, whereas other preventive measures such as hepatitis B vaccination are usually not disputed. Efforts to improve the knowledge of healthcare workers about influenza, its epidemic potential and clinical consequences have contributed to higher immunization rates in some hospitals. Immunization against varicella zoster virus does not result in immunity in all vaccinated persons. This lack of complete protection has infection-control implications, namely the recommendation to wear a mask when caring for clinical cases, regardless of the immunization status. The topic of immunization of healthcare workers has recently been dominated by the discussion of smallpox vaccination, which was promoted by the American public-health authorities for some groups of healthcare workers. SUMMARY: Immunization is a preventive measure that is highly cost-effective. Healthcare workers are responsible for the safety and well-being of their patients and should do their utmost to prevent the transmission of infectious pathogens to them. Another positive result of the adherence of healthcare workers to the recommended immunization schedule is the improved self-protection at the workplace. Immunization against some highly contagious infectious agents has been recommended for many years. The list is now being expanded again by the recommendation of smallpox vaccination. Regarding this indication, several questions and safety issues must be resolved in order to positively influence the currently rather sceptical attitude of healthcare workers towards this vaccine.     

Immunization for prevention of infective endocarditis

Immunization has been used for many years to prevent certain infectious diseases. Often it is targeted to populations at increased risk of a particular infection. Patients at increased risk of infective endocarditis can be identified and would be eligible candidates for immunization if vaccines were available to prevent common bacterial causes of infective endocarditis. The idea of using preventive therapy among patients at increased risk of infective endocarditis is not novel, and recommendations for use of antibiotics prior to performing certain invasive procedures have been in place for years. Findings from immunization experiments using animal models of experimental endocarditis support the notion that vaccine development is appropriate for study in humans, and these findings are reviewed in this paper.     

Immunization Precautions for Highly Sensitive Individuals

An examination was conducted of the relationship between Peak Expiratory Flow Rate (PEFR) measurements obtained in the homes of two boys with asthma and the predictability of asthma episodes. An approach was developed for assessing the predictive utility of Pefr data. Results indicated approximately three-fold increases in the predictability of asthma episodes for the two experimental subjects. Potential applications of these results to the manage-ment of asthma are discussed.     

Immunization for prevention of infective endocarditis

Immunization has been used for many years to prevent certain infectious diseases. Often it is targeted to populations at increased risk of a particular infection. Patients at increased risk of infective endocarditis can be identified and would be eligible candidates for immunization if vaccines were available to prevent common bacterial causes of infective endocarditis. The idea of using preventive therapy among patients at increased risk of infective endocarditis is not novel, and recommendations for use of antibiotics prior to performing certain invasive procedures have been in place for years. Findings from immunization experiments using animal models of experimental endocarditis support the notion that vaccine development is appropriate for study in humans, and these findings are reviewed in this paper.     

Lipid markers for atherosclerosis

Atherogenesis results from the simultaneous occurrence of 2 important processes: platelet-endothelial interaction, with its consequences mediated by the platelet-derived growth factor, and lipid accumulation. Lipid accumulation results from the balance or imbalance of cellular uptake of lipoproteins versus the removal of cholesterol esters. Uptake results from activity of the low-density lipoprotein (LDL) receptor of smooth muscle cells and fibroblasts, modified LDL receptor and remnant receptors of macrophages. Cholesterol-ester removal is regulated by apolipoprotein A-l. Low levels of apolipoprotein A-l are found in most patients with clinically significant coronary artery disease, suggesting that defects in cellular cholesterol ester removal may play an important role in atherogenesis.     

免疫治疗动脉粥样硬化的研究进展

动脉粥样硬化是引起心脑血管疾病的主要原因。免疫反应在动脉粥样硬化的不同阶段扮演着不同角色,通过抑制动脉粥样硬化发生前的免疫发应,或者选择性的活化抗动脉粥样硬化的免疫反应治疗动脉粥样硬化正成为人们关注的热点。本文就近年来免疫治疗动脉粥样硬化的研究进展作一综述。