Vaccine against MAC?

Posted by Armando @bolso1, Nov 19, 2020

Does anybody know about a vaccine against MAC? I found the paper ["Protection against Mycobacterium avium by DNA Vaccines Expressing Mycobacterial Antigens as Fusion Proteins with Green Fluorescent Protein" (INFECTION AND IMMUNITY, Aug. 1999, Vol. 67, No. 8 p. 4243–4250)] that claimed to be "…first report of successful DNA vaccination against M. avium", but nothing else.

Hello @bolso1 and welcome to Mayo Clinic Connect. I understand you are interested in learning if any members know about a vaccine for MAC. Members like @sueinmn @thumperguy and @nannette , to name a few, are very active in our MAC discussions and may have more information to share with you that they have come across in their research.

Can I ask if you have MAC and how your research got you on the path to seeking vaccine information?

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Thank you, Amanda! I don't suffer from MAC, my wife does. We have been studying about it and became curious about the existence of a vaccine, given MAC's growing importance worldwide and its biological proximity to tuberculosis, against which a vaccine has long been in use.

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@bolso! now that is a great question, if they can do it so fast for covid why not MAC.

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@heathert

@bolso! now that is a great question, if they can do it so fast for covid why not MAC.

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So I am thinking Heather how one would vaccinate for MAC. It’s not contagious person to person like TB so it’s not like you would vaccinate the whole world. It would have to be something that targets the disease itself after a person gets it. I’d like to see that DNA research article in its entirety. What do you think? irene5

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@bolso1 I printed out the article from the American Journal of Microbiology and will bring it to my appointment tomorrow and ask one of the doctors I see about this vaccination idea. Thank you for bringing this up. irene5

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@irene5

So I am thinking Heather how one would vaccinate for MAC. It’s not contagious person to person like TB so it’s not like you would vaccinate the whole world. It would have to be something that targets the disease itself after a person gets it. I’d like to see that DNA research article in its entirety. What do you think? irene5

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@irene so true, good thinking. Yes for after you have MAC, Im not sure, I feel meds or inhaling would be the best option but who knows, I havnt seen the DNA research.

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@irene5

So I am thinking Heather how one would vaccinate for MAC. It’s not contagious person to person like TB so it’s not like you would vaccinate the whole world. It would have to be something that targets the disease itself after a person gets it. I’d like to see that DNA research article in its entirety. What do you think? irene5

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I don't think that it would be necessary to vaccinate the whole world, nor that it would have to be administered after a person gets it. I think that we could make an analogy with the shingles/chickenpox situation (https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054), in that the vaccine against shingles is not given to the whole world but to those who are in higher risk groups. I think that in the same way that having developed a vaccine against chickenpox probably helped to develop a vaccine against shingles, the development of a vaccine against MAC could be aided by the experience with the vaccine against TB.
The demand for a vaccine against MAC has been increasing: In a 2011 paper (https://www.atsjournals.org/doi/full/10.1164/rccm.201111-2016OC) they studied a nationally representative 5% sample of Medicare Part B beneficiaries from 1997 to 2007, and found that the annual prevalence significantly increased from 20 to 47 cases/100,000 persons, or 8.2% per year. I wonder what has happened between 2007 and now, and compare it with, say, the increase in shingles.

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@bolso1 This is interesting and intriguing to me. I certainly understand the shingles vaccine, but that vaccine is against a virus not a bacteria. I also understand BCG because 6 of my children are Chinese. Two had to be on TB meds for a year because their skin test reacts. I have a Umass appointment with my pulmonologist today and have questions I was going to ask him. I will add this to my list. He works with my ID doctor. irene5

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There has been some recent research about a vaccine for MAC that sounds promising. I cannot post the links from my phone, but Google mycobabterium avium complex vaccine and look for articles from 2019.
Probably the biggest issue is that ours is something of an "orphan" only affecting about .1% of the population and not contagious, so not a very high priority.
Let us know of you learn anything new from your doc @irene5 .
Sue

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@sueinmn

There has been some recent research about a vaccine for MAC that sounds promising. I cannot post the links from my phone, but Google mycobabterium avium complex vaccine and look for articles from 2019.
Probably the biggest issue is that ours is something of an "orphan" only affecting about .1% of the population and not contagious, so not a very high priority.
Let us know of you learn anything new from your doc @irene5 .
Sue

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Ok – thank you Sue. And I will. Irene

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@sueinmn

There has been some recent research about a vaccine for MAC that sounds promising. I cannot post the links from my phone, but Google mycobabterium avium complex vaccine and look for articles from 2019.
Probably the biggest issue is that ours is something of an "orphan" only affecting about .1% of the population and not contagious, so not a very high priority.
Let us know of you learn anything new from your doc @irene5 .
Sue

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@sueinmn Good morning Sue. I had quite a lengthy discussion with my pulmonologist at UMASS on Friday. I brought the research article with me that @bolso1 had referenced. What I gleaned from our conversation is that while it is good research, it is missing a next step which would be to see if humans would develop the same antibodies as the mice. Unfortunately, a vaccine would not help those of us who are already diagnosed/struggling with MAC infection. irene5

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I want to share an interesting and recent paper (attached) that concludes that BCG-vaccination induces non-tuberculous mycobacterial (NTM) cross-reactive immunity, and has the potential for use as a vaccine or immunotherapy to prevent and/or treat pulmonary NTM disease.
Also, in the Introduction, the authors stated: "In North America, the incidence of pulmonary nontuberculous mycobacteria (NTM) is higher than the incidence of tuberculosis (TB) (1). In addition, the prevalence of multiple NTM infections and the mortality rates associated with NTM infections are increasing (2–5). A study of Medicare part B beneficiaries showed that the prevalence of NTM increased from 20 to 47 per 100,000 persons between 1997 and 2007, an increase of 8.2% per year (2). A more recent report estimated that the number of pulmonary NTM cases in the US increased by at least another two-fold between 2010 and 2014 (5). The causes for these increases in prevalence of pulmonary NTM are not known."

Shared files

fimmu-10-00234 (fimmu-10-00234.pdf)

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