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BCG (Bacillus Calmette-Guérin) is a live-attenuated vaccine derived from a strain of *Mycobacterium bovis*. Originally developed over a century ago for the prevention of tuberculosis, it has become a cornerstone of immunotherapy, particularly as the standard-of-care intravesical treatment for non-muscle-invasive bladder cancer (NMIBC). Beyond its primary indications, BCG is recognized for inducing 'trained immunity'—a process of epigenetic and metabolic reprogramming of innate immune cells (such as monocytes and natural killer cells) that enhances the host's response to unrelated pathogens and inflammatory insults. This pleiotropic effect has spurred extensive clinical investigation into its potential for treating or preventing diverse conditions, including Alzheimer's disease, type 1 diabetes, asthma, and chronic obstructive pulmonary disease (COPD).
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