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Bacillus Calmette-Guérin Moreau RJ strain is a live attenuated strain of *Mycobacterium bovis* developed as part of the Bacillus Calmette-Guérin (BCG) vaccine lineage. It is a variant of the original BCG used extensively in Brazil for both vaccination against tuberculosis and for intravesical immunotherapy of non-muscle invasive bladder cancer (NMIBC)[2][3][9]. The Moreau RJ strain is genetically distinct and lacks certain virulence-associated lipid components, notably PDIM and PGL, which may contribute to its reduced side effect profile compared to other BCG strains[2]. Mechanistically, it acts by stimulating the immune system, inducing proinflammatory cytokine responses and activating innate and adaptive immunity, leading to a long-lasting antitumor and antimicrobial effect[1][4][6]. It is regarded as highly immunogenic, with a favorable safety profile, and is comparable in efficacy to other established BCG strains for NMIBC with potentially fewer adverse events[2][3]. The strain also influences the expression of immune markers such as TLR4, B7-1, and Dectin-1 on monocytes, reflecting its effects on innate immune responses[6]. In Brazil, the Ataulpho de Paiva Foundation has been the primary developer and manufacturer, with vaccine use shifting from oral to intradermal administration since the 1970s[9]. BCG Moreau RJ is used primarily for tuberculosis prevention and bladder cancer therapy.
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