Hiltunen M, Lönnrot M, Hyöty H
Department of Virology, University of Tampere, Medical School, and Tampere University Hospital, Finland.
Drug Saf. 1999 Mar;20(3):207-12. doi: 10.2165/00002018-199920030-00001.
Recent evidence from animal studies has raised the possibility that immunisation by vaccines can influence the pathogenesis of type I (insulin-dependent) diabetes mellitus. In non-obese diabetic mice and biobreeding rats, complete Freund's adjuvant and bacillus Calmette-Guérin (BCG) vaccine have successfully been used to interrupt the development of diabetes mellitus. This effect is probably mediated by nonspecific suppression of the autoimmune process. A number of attempts have also been made to assess the impact of parenteral immunisation on type 1 diabetes mellitus in humans. Epidemiological evidence has not indicated any clear link between BCG vaccination and the development of diabetes mellitus in humans. Some reports have suggested that natural mumps or mumps vaccinations can induce islet cell autoimmunity, but there is no evidence that mumps-measles-rubella mass vaccination programmes have changed the incidence of diabetes mellitus in any population. An independent protective role of measles virus has been suggested in one study. Recent studies have indicated that enterovirus infections may induce beta cell autoimmunity and clinical diabetes. The only currently available enterovirus vaccine is the poliovirus vaccine which, in theory, could modulate the protection against other enteroviruses by inducing cross-reactive T cell immune responses; however, this hypothesis has not been tested so far. In conclusion, there is no clear evidence that any currently used vaccine can prevent or induce diabetes in humans. However, only a few studies are available on the subject and therefore the possibility of a link between vaccination and diabetes mellitus cannot be excluded.
动物研究的最新证据表明，疫苗免疫可能会影响I型（胰岛素依赖型）糖尿病的发病机制。在非肥胖糖尿病小鼠和生物繁殖大鼠中，完全弗氏佐剂和卡介苗（BCG）已成功用于阻断糖尿病的发展。这种作用可能是由自身免疫过程的非特异性抑制介导的。人们也进行了一些尝试来评估肠道外免疫对人类1型糖尿病的影响。流行病学证据并未表明卡介苗接种与人类糖尿病的发展之间存在任何明确的联系。一些报告表明，自然感染腮腺炎或接种腮腺炎疫苗可诱导胰岛细胞自身免疫，但没有证据表明麻疹-腮腺炎-风疹大规模疫苗接种计划改变了任何人群中糖尿病的发病率。一项研究表明麻疹病毒具有独立的保护作用。最近的研究表明，肠道病毒感染可能诱导β细胞自身免疫和临床糖尿病。目前唯一可用的肠道病毒疫苗是脊髓灰质炎病毒疫苗，理论上，它可以通过诱导交叉反应性T细胞免疫反应来调节对其他肠道病毒的保护作用；然而，这一假设迄今尚未得到验证。总之，没有明确的证据表明任何目前使用的疫苗能够预防或诱发人类糖尿病。然而，关于这一主题的研究很少，因此不能排除疫苗接种与糖尿病之间存在联系的可能性。
