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BCG-derived outer membrane vesicles (B-OMVs or BCG-MVs) are acellular, exosome-like nanoscale extracellular vesicles harvested from Bacillus Calmette-Guérin (BCG), the vaccine strain of Mycobacterium bovis. These vesicles contain proteins, nucleic acids, and lipids from their parent bacterium, and act as potent immunostimulatory agents by inducing both adaptive and innate immune responses, including "trained immunity" — a type of innate immune memory. Mechanistically, B-OMVs can activate toll-like receptor 2 (TLR2)-dependent signaling, promoting hematopoietic stem cell expansion and myelopoiesis, enhancing aerobic glycolysis and epigenetic reprogramming in bone-marrow cells. Preclinical studies indicate that B-OMVs provide protection against experimental polymicrobial sepsis and reduce mycobacterial burden in animal models, positioning them as novel vaccine candidates or immunomodulators with improved safety profiles compared to live BCG[1][2][3][8]. Their development aims to address limitations of conventional BCG vaccination, such as adverse reactions and inconsistent immune memory[1][2][3]. Current status: preclinical research; not yet in human clinical trials.
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