BCG reduces Alzheimer's risk in bladder cancer patients

Treatment of bladder cancer patients with tuberculosis vaccine BCG lowers the risk of Alzheimer's disease (AD), finds a recent study.

Israel: According to the study, published in the PLOS One journal, bladder cancer patients treated with BCG vaccine are significantly less likely to develop AD at any age than patients who were not treated. The finding suggests that the BCG (Bacillus Calmette-Guérin) vaccine might also reduce the risk of AD in the general population.

Alzheimer’s disease affects one in ten people older than 65 years. Still, there exists no cure or even disease-modifying treatment for this disease. The immune system plays a major role in the pathogenesis of AD. The exact mechanism of BCG anticancer activity has not been deciphered, but it is well recognized that BCG manifests immune effects. BCG vaccine is known to reduce the recurrence of non-muscle invasive bladder cancer.

Theoretical considerations suggested that treatment with BCG may decrease the risk of AD. Hervé Bercovier, Department of Microbiology and Molecular Genetics, Hebrew University Jerusalem, Israel, and colleagues tested this hypothesis on a natural population of bladder cancer patients.

The researchers collected data on a total of 1371 patients (1134 males and 237 females) who were followed for at least one year after the diagnosis of bladder cancer. All bladder cancer patients presenting with AD or developing AD within one-year following diagnosis of bladder cancer were excluded. The mean age at diagnosis of bladder cancer was 68.1 years (SD 13.0). Adjuvant post-operative intra-vesical treatment with BCG was given to 878 (64%) of these patients. The median period post-operative follow-up was 8 years.

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Key findings of the study include:

• During follow-up, 65 patients developed AD at a mean age of 84 years (SD 5.9), including 21 patients (2.4%) who had been treated with BCG and 44 patients (8.9%) who had not received BCG.


• Patients who had been treated with BCG manifested more than 4-fold less risk for AD than those not treated with BCG.


• The Cox proportional hazards regression model and the Kaplan-Meier analysis of AD free survival both indicated high significance: patients not treated with BCG had a significantly higher risk of developing AD compared to BCG treated patients (HR 4.778, 95%CI: 2.837–8.046, p = 4.08x10^-9 and Log Rank Chi-square 42.438, df = 1, p = 7.30x10^-11, respectively).


• Exposure to BCG did not modify the prevalence of Parkinson’s disease, 1.9% in BCG treated patients and 1.6% in untreated (Fisher’s Exact Test, p = 1).

"Findings from this retrospective study suggests that BCG treatment might also reduce the incidence of AD in the general population. Confirmation of such effects of BCG in other retrospective studies would support prospective studies of BCG in AD," concluded the authors.

The study, "Bacillus Calmette-Guérin (BCG) therapy lowers the incidence of Alzheimer’s disease in bladder cancer patients," is published in the journal PLOS One.

DOI: https://doi.org/10.1371/journal.pone.0224433