| Budget Amount *help |
¥2,700,000 (Direct Cost: ¥2,700,000)
Fiscal Year 2004: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 2003: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Research Abstract |
Delayed type hypersensitivity response to tuberculin is an important marker of T helper 1 mediated acquired immunity. Since the disabled elderly with depressed tuberculin responses show an increased risk of pneumonia, we examined the effect of Bacillus Calmette-Guerin (BCG) administration on the development of pneumonia in these subjects. Eighty-eight disabled older patients with depressed tuberculin responses were randomly assigned with BCG inoculation (n = 44) or without inoculation (n = 44, NT group). Forty-one (93%) of the 44 patients assigned with BCG inoculation showed positive tuberculin conversion (CT group). Sixty-seven age-matched patients with positive tuberculin responses (PT group) were also enrolled. We prospectively compared the rates of development of pneumonia for two years among these three groups. During follow-up, new pneumonia was diagnosed in 19 of the 44 patients (42%) in the NT group, 6 (15%) of the 41 patients in the CT group, and 9 (13%) of the 67 patients in the PT group. According to the Cox regression model, a hazard ratio of developing pneumonia in the NT group compared with the CT group was 3.22 (95% CI 1.03 -9.96, P = 0.03). Furthermore, the rate of hospitalization due to pneumonia was significantly higher in the NT group compared with the CT group with a relative risk of 7.14 (95% CI 1.41 -36.1, P = 0.03). Conversely, there was no significant difference in the risk of pneumonia between the CT group and the PT group (P= 0.70). These findings suggest that BCG inoculation could re-activate the immune system and reduce the risk of pneumonia in the disabled elderly.
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