Massachusetts Medical Society: The Beneficial Effects of the 100-Year-Old BCG Vaccine in Type 1 Diabetes - 2018 Annual Oration

The Beneficial Effects of the 100-Year-Old BCG Vaccine in Type 1 Diabetes - 2018 Annual Oration

The Beneficial Effects of the 100-Year-Old BCG Vaccine in Type 1 Diabetes

BCG is a live attenuated bacterial vaccine that contains the avirulent tuberculosis strain Mycobacterium bovis.  BCG has historically been given to protect against tuberculosis and, since its introduction in 1921, has been the most widely administered vaccine in the history of medicine.  BCG is considered to be extremely safe and roughly 100 million children per year globally receive the vaccine. BCG is also one of the most affordable medicines, costing less than a dollar a dose in many parts of the world.

Expanded use of BCG is occurring globally for the treatment of diverse human autoimmune diseases, allergies and to alter immunity to infections. The MGH based and ongoing clinical trials, centered mostly on type 1 diabetes, have recently shown that limited BCG dosing even in long term type 1 diabetics can restore blood sugars to the near normal range with over 8 years of clinical trial monitoring. These restored blood sugars in the normal range are not associated with hypoglycemia, a differentiator from insulin therapy and many additional clinical trials are underway.

The re-use of this affordable and safe drug to clinically regulate type 1 diabetic subject blood sugars is a lesson in the power of generic drug development for affordable and improved care. With new and existing federal legislation on the rights of patients for Expanded Access to generic drugs it is important for the medical community to be aware of these Boston based and global efforts as well to implement these possible transformative and affordable health care solutions.  

Learning Objectives

  • Discuss how repeat BCG vaccines can help restore immune balance in autoimmune disorders, such as type 1 diabetes, by inducing an increase in Treg suppressor T-cells and by killing cytotoxic T-cells. 
  • Describe the beneficial effects of repeat BCG vaccination on glycemic control in type 1 diabetes, even in patients with advanced disease of greater than 20 years of duration, through induction of accelerated and regulated glucose uptake with aerobic glycolysis
  • Summarize the rationale for re-introduction of the BCG vaccine for prevention of allergies and autoimmune disorders such as type 1 diabetes.

Faculty
Denise Faustman, MD, PhD
Denise Faustman's research objective is to introduce new therapeutic concepts to treat autoimmune diseases with a focus on type 1 diabetes.  These studies start with the basic science and translate through clinical trial design, manufacturing and clinical trial implementation.  In the Immunobiology Lab, she had lead teams that worked to uncover the basic molecular and immunological mechanisms behind human and murine immune pathogenesis. She is international leader as it relates to the TNF superfamily of receptors with an emphasis on the TNFR2 signaling, a pathway that is deficient in autoimmunity and a pathway used by select microorganism to restore immune balance.  She has worked for over 15 years on using surrogate and affordable drugs like the BCG vaccine to speed delivery of the autoimmune innovations to the public.  In total, Dr Faustman directs over 7 advanced clinical trials including all the pre-clinical development, drug manufacturing and FDA interface and is the President of the Global Autoimmune Collaboration, an international group aimed to launch affordable healthcare.

Dr. Faustman's research has earned her notable awards such as the Oprah Achievement Award for “Top Health Breakthrough by a Female Scientist”, the "Women in Science Award" from the American Medical Women’s Association and Wyeth Pharmaceutical Company for her contributions to autoimmune disease research, and the Goldman Philanthropic Partnerships/Partnership for Cures for research to find an effective treatment for type 1 diabetes.  Her achievement earned her the prestigious National Institutes of Health and National Library of Medicine “Changing the Face of Medicine” Award as one of 300 American physicians (one of 35 in research) honored for seminal scientific achievements in the United States. This year she will receive the French Prize in Medicine for her work on BCG, a vaccine originally developed in France.

Dr. Faustman earned her MD and PhD from Washington University School of Medicine in St. Louis, Missouri, and completed her internship, residency, and fellowships in Internal Medicine and Endocrinology at the Massachusetts General Hospital in Boston, Massachusetts. 
 
Course Fees
MMS Member Physicians: Free                 
Nonmember Physicians: $15                 
Allied Health Professionals: $6  

Format:  Video  

CME Credit: 1.00 AMA PRA Category 1 Credits™

Accreditation Statement  
The Massachusetts Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement 
The Massachusetts Medical Society designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MOC Approval Statement 
Through the American Board of Medical Specialties ("ABMS") ongoing commitment to increase access to practice relevant Maintenance of Certification ("MOC") Activities through the ABMS Continuing Certification Directory , this activity has met the requirements as an MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:  

Allergy and Immunology
Anesthesiology 
Family Medicine
Medical Genetics and Genomics
Nuclear Medicine
Physical Medicine and Rehabilitation
Plastic Surgery 
Preventive Medicine
Psychiatry and Neurology
Radiology
Thoracic Surgery
Urology

National Commission on Certification of Physicians Assistant (NCCPA).
Physician Assistants may claim a maximum of 1.00 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.

A score of 70% or higher is required to receive AMA PRA Category 1 Credit™.

Activity Term
Original Released Date: February 22, 2019            
Review Date: N/A      
Termination Date: February 22, 2022        

System requirements:
Desktops/Laptops

Windows, XP, Vista, 7, 8
Mac OSX 10.6 higher
Most modern browsers including:
IE8,9,10
Firefox 18.0+
Chrome 26+
Safari 5+
Flash player  is required for some Online CME courses.
 
Mobile/Tablet
iOS devices beginning with OS version 5 or higher (includes, iPhone, ipad and iTouch devices)
Android devices including tablets and phones.
Windows RT and tablets on Windows 8 are also supported.


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