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Sánchez-Ramón S, Fernández-Paredes L, Saz-Leal P, Diez-Rivero CM, Ochoa-Grullón J, Morado C, Macarrón P, Martínez C, Villaverde V, de la Peña AR, Conejero L, Hernández-Llano K, Cordero G, Fernández-Arquero M, Gutierrez BF, Candelas G. Sublingual Bacterial Vaccination Reduces Recurrent Infections in Patients With Autoimmune Diseases Under Immunosuppressant Treatment. Front Immunol 2021; 12:675735. [PMID: 34149711 PMCID: PMC8212043 DOI: 10.3389/fimmu.2021.675735] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/26/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction Conventional or biologic disease-modifying anti-rheumatic drugs (DMARDs) are the mainstay of treatment for systemic autoimmune disease (SAD). Infectious complications are a major concern in their use. Objective To evaluate the clinical benefit of sublingual mucosal polybacterial vaccines (MV130 and MV140), used to prevent recurrent respiratory and urinary tract infections, in patients with SAD and secondary recurrent infections following conventional or biologic DMARDs. Methods An observational study in SAD patients with recurrent respiratory tract infections (RRTI) and/or recurrent urinary tract infections (RUTI) was carried out. All patients underwent mucosal (sublingual) vaccination with MV130 for RRTI or with MV140 for RUTI daily for 3 months. Clinical evaluation was assessed during 12 months of follow-up after the first dose, i.e., 3 months under treatment and 9 months once discontinued, and compared with the previous year. Results Forty-one out of 55 patients completed 1-year follow-up. All patients were on either conventional or biologic DMARDs. A significant decrease in the frequency of RUTI (p<0.001), lower respiratory tract infections (LRTI) (p=0.009) and upper respiratory tract infections (URTI) (p=0.006) at 12-mo with respect to the previous year was observed. Antibiotic prescriptions and unscheduled medical visits decreased significantly (p<0.020) in all groups. Hospitalization rate also declined in patients with RRTI (p=0.019). The clinical benefit demonstrated was concomitant to a significant increase in both anti-S. pneumoniae IgA and IgG antibodies following MV130 vaccination. Conclusions Sublingual polybacterial vaccines prevent recurrent infections in patients with SAD under treatment with immunosuppressant therapies, supporting a broad non-specific anti-infectious effect in these patients.
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Affiliation(s)
- Silvia Sánchez-Ramón
- Department of Clinical Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Lidia Fernández-Paredes
- Department of Clinical Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Paula Saz-Leal
- Department of Innovation and Development, Inmunotek S.L., Alcalá de Henares, Spain
| | - Carmen M Diez-Rivero
- Department of Innovation and Development, Inmunotek S.L., Alcalá de Henares, Spain
| | - Juliana Ochoa-Grullón
- Department of Clinical Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Concepción Morado
- Department of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain
| | - Pilar Macarrón
- Department of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain
| | - Cristina Martínez
- Department of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Laura Conejero
- Department of Innovation and Development, Inmunotek S.L., Alcalá de Henares, Spain
| | - Keyla Hernández-Llano
- Department of Clinical Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Gustavo Cordero
- Department of Clinical Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Gloria Candelas
- Department of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain
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