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The Bacillus Calmette–Guérin (BCG) vaccine is a live attenuated bacterial vaccine derived from a strain of *Mycobacterium bovis*. Originally developed over a century ago for the prevention of tuberculosis, it is now also a standard intravesical immunotherapy for non-muscle invasive bladder cancer. The vaccine's mechanism involves 'trained immunity,' where it epigenetically reprograms innate immune cells (such as monocytes and natural killer cells) to mount enhanced, non-specific responses against a broad spectrum of pathogens. Currently, the University of Birmingham is conducting the Phase IV STABILISE trial to evaluate whether BCG vaccination can reduce exacerbations in adults with chronic obstructive pulmonary disease (COPD) who are tuberculosis-negative.
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