{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:57:20Z","timestamp":1740142640045,"version":"3.37.3"},"reference-count":23,"publisher":"FapUNIFESP (SciELO)","issue":"5","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVES  To evaluate the efficacy of mucosal bacterial vaccines (MBV) in reducing the number of exacerbations in patients with chronic respiratory disease.  METHODS  A prospective cohort study of patients followed at the Pneumology Unit of the University and Hospital Centre of Coimbra, with frequent infectious exacerbations (3 or more) despite the best therapeutic strategies employed. MBV was used as additional therapy. The number of exacerbations 1 year before therapy and 1 year after it were analyzed.  RESULTS  A sample of 11 individuals, 45.5% male, mean age 62.5 years. Eight patients had non-cystic fibrosis bronchiectasis, 2 COPD (1 on long-term oxygen therapy), and 1 patient with Mounier Kuhn\u2019s syndrome. Three patients were on azithromycin, 1 on inhaled colistin, and 2 on inhaled tobramycin. Out of the 11 patients, one presented complication (fever), which led to a suspension of therapy (excluded from results). Of the 10 patients who completed treatment, 5 had bacterial colonization and were submitted to a custom vaccine. The remaining 6 completed the standard composition. The average of infectious exacerbations in the previous year was 4.3 (0.7 with hospitalization). In the year after therapy, the mean number was 1.5 (0.5 with hospitalization).  CONCLUSION  The results obtained in this study favor the use of bacterial immunostimulation to reduce the frequency of RRIs in patients with chronic respiratory disease.<\/jats:p>","DOI":"10.1590\/1806-9282.66.5.659","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T21:15:15Z","timestamp":1593810915000},"page":"659-665","source":"Crossref","is-referenced-by-count":0,"title":["Mucosal bacterial vaccines in clinical practice \u2013 a novel approach to an old problem?"],"prefix":"10.1590","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3162-9170","authenticated-orcid":false,"given":"Jo\u00e3o Neiva","family":"Machado","sequence":"first","affiliation":[{"name":"Universidade e Centro Hospitalar de Coimbra,  Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1727-7730","authenticated-orcid":false,"given":"Jos\u00e9 Coutinho","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade e Centro Hospitalar de Coimbra,  Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1250-5685","authenticated-orcid":false,"given":"Teresa","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade e Centro Hospitalar de Coimbra,  Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1780-8685","authenticated-orcid":false,"given":"Cid\u00e1lia","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Universidade e Centro Hospitalar de Coimbra,  Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2020,5]]},"reference":[{"series-title":"Recent advances in novel antibacterial development","author":"Mart\u00edn-Rodr\u00edguez AJ","key":"ref1"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.reuma.2018.10.012","article-title":"Vacunas antiinfecciosas de mucosas en la profilaxis de infecciones recurrentes: m\u00e1s all\u00e1 de las vacunas convencionales","volume":"16","author":"S\u00e1nchez Ram\u00f3n S","year":"2020","journal-title":"Reumatol Clin"},{"issue":"3","key":"ref3","first-page":"335","article-title":"Bacterial lysate in the prevention of acute exacerbation of COPD and in respiratory recurrent infections","volume":"2","author":"Braido F","year":"2007","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1046\/j.1469-0691.8.s.2.5.x","article-title":"Surveillance of resistance in bacteria causing community-acquired respiratory tract infections","volume":"8","author":"Felmingham D","year":"2002","journal-title":"Clin Microbiol Infect"},{"issue":"5","key":"ref5","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1378\/chest.126.5.1645","article-title":"Oral purified bacterial extracts in chronic bronchitis and COPD: systematic review","volume":"126","author":"Steurer-Stey C","year":"2004","journal-title":"Chest"},{"issue":"1","key":"ref6","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1365-2249.2011.04320.x","article-title":"Sublingual therapeutic immunization with a polyvalent bacterial preparation in patients with recurrent respiratory infections: immunomodulatory effect on antigen-specific memory CD4+ T cells and impact on clinical outcome","volume":"164","author":"Alecsandru D","year":"2011","journal-title":"Clin Exp Immunol"},{"issue":"25","key":"ref7","doi-asserted-by":"crossref","first-page":"4175","DOI":"10.1016\/j.vaccine.2010.04.013","article-title":"Persistence of mucosal and systemic immune responses following sublingual immunization","volume":"28","author":"Negri DR","year":"2010","journal-title":"Vaccine"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1038\/nm1213","article-title":"Mucosal immunity and vaccines","volume":"11","author":"Holmgren J","year":"2005","journal-title":"Nat Med"},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/01.all.0000246617.41871.40","article-title":"Sublingual immunotherapy: update 2006","volume":"6","author":"Passalacqua G","year":"2006","journal-title":"Curr Opin Allergy Clin Immunol"},{"issue":"2","key":"ref10","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1159\/000195827","article-title":"Local immunity in patients with chronic bronchitis and the effects of a bacterial extract, Broncho-Vaxom, on T lymphocytes, macrophages, gamma-interferon and secretory immunoglobulin A in bronchoalveolar lavage fluid and other variables","volume":"57","author":"Emmerich B","year":"1990","journal-title":"Respiration"},{"issue":"3","key":"ref11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1159\/000195723","article-title":"Oral immunotherapy of chronic bronchitis: a double-blind placebo-controlled multicenter study","volume":"55","author":"Cvoriscec B","year":"1989","journal-title":"Respiration"},{"key":"ref12","series-title":"Reversible microbial colonization of germ-free mice reveals the dynamics of IgA immune responses","first-page":"1705","volume":"328","author":"Hapfelmeier S","year":"2010"},{"issue":"16","key":"ref13","doi-asserted-by":"crossref","first-page":"9203","DOI":"10.1073\/pnas.97.16.9203","article-title":"T cell homeostasis in patients with rheumatoid arthritis","volume":"97","author":"Koetz K","year":"2000","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"6","key":"ref14","doi-asserted-by":"crossref","first-page":"3851","DOI":"10.1128\/IAI.68.6.3581-3586.2000","article-title":"Gram-positive bacteria are potent inducers of monocytic interleukin-12 (IL-12) while gram-negative bacteria preferentially stimulate IL-10 production","volume":"68","author":"Hessle C","year":"2000","journal-title":"Infect Immun"},{"issue":"4","key":"ref15","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1038\/mi.2012.121","article-title":"Anti-bacterial and anti-toxic immunity induced by a killed whole-cell-cholera toxin B subunit cholera vaccine is essential for protection against lethal bacterial infection in mouse pulmonary cholera model","volume":"6","author":"Kang SS","year":"2013","journal-title":"Mucosal Immunol"},{"issue":"12","key":"ref16","doi-asserted-by":"crossref","first-page":"7071","DOI":"10.4049\/jimmunol.1000110","article-title":"Phagocytosis and phagosome acidification are required for pathogen processing and MyD88-dependent responses to Staphylococcus aureus","volume":"184","author":"Ip WK","year":"2010","journal-title":"J Immunol"},{"issue":"90","key":"ref17","doi-asserted-by":"crossref","DOI":"10.3791\/52036","article-title":"Sublingual Immunotherapy as an alternative to induce protection against acute respiratory infections","author":"Mu\u00f1oz-Wolf N","year":"2014","journal-title":"J Vis Exp"},{"issue":"9","key":"ref18","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1080\/21645515.2019.1581537","article-title":"Mucosal bacterial immunotherapy with MV130 highly reduces the need of tonsillectomy in adults with recurrent tonsillitis","volume":"15","author":"Garc\u00eda Gonz\u00e1lez LA","year":"2019","journal-title":"Hum Vaccin Immunother"},{"key":"ref19","article-title":"Sublingual vaccine: new challenge in the prevention of recurrent infections in autoimmune diseases","volume":"76","author":"Hern\u00e1ndez Llano K","year":"2017","journal-title":"Ann Rheum Dis"},{"year":"2015","author":"Ochoa-Grull\u00f3n J","key":"ref20"},{"issue":"25","key":"ref21","doi-asserted-by":"crossref","first-page":"4175","DOI":"10.1016\/j.vaccine.2010.04.013","article-title":"Persistence of mucosal and systemic immune responses following sublingual immunization","volume":"28","author":"Negria DR","year":"2010","journal-title":"Vaccine"},{"issue":"1","key":"ref22","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s00192-012-1853-5","article-title":"Evaluation of a therapeutic vaccine for the prevention of recurrent urinary tract infections versus prophylactic treatment with antibiotics","volume":"24","author":"Lorenzo-G\u00f3mez MF","year":"2013","journal-title":"Int Urogynecol J"},{"issue":"4","key":"ref23","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1038\/mi.2016.112","article-title":"MV140, a sublingual polyvalent bacterial preparation to treat recurrent urinary tract infections, licenses human dendritic cells for generating Th1, Th17, and IL-10 responses via Syk and MyD88","volume":"10","author":"Benito-Villalvilla C","year":"2017","journal-title":"Mucosal Immunol"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ramb\/v66n5\/1806-9282-ramb-66-5-0659.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T22:01:48Z","timestamp":1611439308000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302020000500659&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":23,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["S0104-42302020000500659"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.66.5.659","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"type":"electronic","value":"1806-9282"},{"type":"print","value":"0104-4230"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}