Vaccination and autoimmunity-'vaccinosis': a dangerous liaison?
The question of a connection between vaccination and autoimmune illness (or phenomena) is surrounded by controversy. A heated debate is going on regarding the causality between vaccines, such as measles and anti-hepatitis B virus (HBV), and multiple sclerosis (MS). Brain antibodies as well as clinical symptoms have been found in patients vaccinated against those diseases. Other autoimmune illnesses have been associated with vaccinations. Tetanus toxoid, influenza vaccines, polio vaccine, and others, have been related to phenomena ranging from autoantibodies production to full-blown illness (such as rheumatoid arthritis (RA)). Conflicting data exists regarding also the connection between autism and vaccination with measles vaccine. So far only one controlled study of an experimental animal model has been published, in which the possible causal relation between vaccines and autoimmune findings has been examined: in healthy puppies immunized with a variety of commonly given vaccines, a variety of autoantibodies have been documented but no frank autoimmune illness was recorded. The findings could also represent a polyclonal activation (adjuvant reaction). The mechanism (or mechanisms) of autoimmune reactions following immunization has not yet been elucidated. One of the possibilities is molecular mimicry; when a structural similarity exists between some viral antigen (or other component of the vaccine) and a self-antigen. This similarity may be the trigger to the autoimmune reaction. Other possible mechanisms are discussed. Even though the data regarding the relation between vaccination and autoimmune disease is conflicting, it seems that some autoimmune phenomena are clearly related to immunization (e.g. Guillain-Barre syndrome). The issue of the risk of vaccination remains a philosophical one, since to date the advantages of this policy have not been refuted, while the risk for autoimmune disease has not been irrevocably proved. We discuss the pros and cons of this issue (although the temporal relationship (i.e. always 2-3 months following immunization) is impressive).
Shoenfeld
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Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel. shoefel@post.tau.ac.il
Aron-Maor
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A
D000818:Animals; D001168:Arthritis / Q000209:etiology; D001321:Autistic Disorder / Q000209:etiology; D001327:Autoimmune Diseases / Q000209:etiology / Q000276:immunology; D015551:Autoimmunity; D001500:BCG Vaccine / Q000009:adverse effects; D002648:Child; D003920:Diabetes Mellitus / Q000209:etiology; D004195:Disease Models, Animal; D004285:Dogs; D020275:Guillain-Barre Syndrome / Q000209:etiology; D017325:Hepatitis B Vaccines / Q000009:adverse effects; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000209:etiology; D008458:Measles Vaccine / Q000009:adverse effects; D022542:Measles-Mumps-Rubella Vaccine; D009103:Multiple Sclerosis / Q000209:etiology; D009108:Mumps Vaccine / Q000009:adverse effects; D012411:Rubella Vaccine / Q000009:adverse effects; D014611:Vaccination / Q000009:adverse effects*; D017778:Vaccines, Combined / Q000009:adverse effects
D001500:BCG Vaccine; D017325:Hepatitis B Vaccines; D007252:Influenza Vaccines; D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine; D012411:Rubella Vaccine; D017778:Vaccines, Combined