title: Systemic immunotoxicity reactions induced by adjuvanted vaccines.
abstract: Vaccine safety is a topic of concern for the treated individual, the family, the health care personnel, and the others involved in vaccination programs as recipients or providers. Adjuvants are necessary components to warrant the efficacy of vaccines, however the overstimulation of the immune system is also associated with adverse effects. Local reactions are the most frequent manifestation of toxicity induced by adjuvanted vaccines and, with the exception of the acute phase response (APR), much less is known about the systemic reactions that follow vaccination. Their low frequency or subclinical expression meant that this matter has been neglected. In this review, various systemic reactions associated with immune stimulation will be addressed, including: APR, hypersensitivity, induction or worsening of autoimmune diseases, modification of hepatic metabolism and vascular leak syndrome (VLS), with an emphasis on the mechanism involved. Finally, the authors analyze the current focus of discussion about vaccine safety and opportunities to improve the design of new adjuvanted vaccines in the future.
authors.affiliation: Immunotoxicology Laboratory, Toxicology and Biomedicine Center (TOXIMED), Medical Science University, Autopista Nacional Km. 1 1/2, CP 90400 Santiago de Cuba, Cuba; Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho (UNESP), Rua Expedicionarios do Brasil 1621, CEP 14801-902 Araraquara, SP, Brazil; CAPES-PVE/Brasil Grant, Foreigner Visiting Professor Program, Brazil. Electronic address: batistaduhartea@gmail.com.
authors.forename: Alexander
authors.initials: A
authors.lastname: Batista-Duharte
authors.affiliation: Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho (UNESP), Rua Expedicionarios do Brasil 1621, CEP 14801-902 Araraquara, SP, Brazil.
authors.forename: Deivys
authors.initials: D
authors.lastname: Portuondo
authors.affiliation: Immunology Department, Institute of Preclinical and Basic Sciences (ICBP) "Victoria de Girón", University of Medical Sciences of Havana. 146 No. 2504. e/ 25 Ave and 31 Ave, Playa, Havana, Cuba.
authors.forename: O
authors.initials: O
authors.lastname: Pérez
authors.affiliation: Faculty of Pharmaceutical Sciences, Universidade Estadual Paulista Julio Mesquita Filho (UNESP), Rua Expedicionarios do Brasil 1621, CEP 14801-902 Araraquara, SP, Brazil.
authors.forename: Iracilda Zeppone
authors.initials: IZ
authors.lastname: Carlos
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects*; D000818:Animals; D004333:Drug Administration Routes; D006801:Humans; D014612:Vaccines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000276:Adjuvants, Immunologic; D014612:Vaccines
keywords: Action mechanisms; Adjuvant; Immunotoxicity; Systemic reactions; Vaccine