PubMed · 306794
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P H Lagrange. 1978. Immunity in tuberculosis.. https://pubmed.ncbi.nlm.nih.gov/306794/
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On direct comparison of minimal sets of ordered clones from bacterial artificial chromosome (BAC) libraries representing the complete genomes of Mycobacterium tuberculosis H37Rv and the vaccine strain, Mycobacterium bovis BCG Pasteur, two major rearrangements were identified in the genome of M. bovis BCG Pasteur. These were shown to correspond to two tandem duplications, DU1 and DU2, of 29 668 bp and 36 161 bp, respectively. While DU1 resulted from a single duplication event, DU2 apparently arose from duplication of a 100 kb genomic segment that subsequently incurred an internal deletion of 64 kb. Several lines of evidence suggest that DU2 may continue to expand, since two copies were detected in a subpopulation of BCG Pasteur cells. BCG strains harbouring DU1 and DU2 are diploid for at least 58 genes and contain two copies of oriC, the chromosomal origin of replication. These findings indicate that these genomic regions of the BCG genome are still dynamic. Although the role of DU1 and DU2 in the attenuation and/or altered immunogenicity of BCG is yet unknown, knowledge of their existence will facilitate quality control of BCG vaccine lots and may help in monitoring the efficacy of the world's most widely used vaccine.
In the fight against respiratory diseases the well established most effective strategy is their prevention. Mainly the field of screening-caring--so called the second and third levels in prevention--belongs to the competency of the pulmonology specialty, while the key-issue of primary prevention consisting of the reduction of environmental harm and health education is not--or at least not only--the responsibility of the health care system. In the light of national epidemiological data BCG vaccination of the new-born is necessary, however, the system of revaccination of school-age children needs revision. The system of chest screening by rtg nowadays is adapted to the local prevalence of tuberculosis; it is needed to concentrate to high-risk subjects. The effectivity of radiological screening now is recognised internationally and this perspective partly based on our national results. In the care of patients with chronic obstructive pulmonary diseases (COPD) the key-issue is the identification and regular follow-up, care of high-risk subjects with rapid decrease in lung function by effective screening. The most important issue in this work is smoking cessation. Of course, if we could prevent smoking addiction, we could significantly reduce the number of several other widespread diseases, not only lung cancer.
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