Schattner Ami
Department of Medicine, University of Cambridge, School of Clinical Medicine, Level 5, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
Vaccine. 2005 Jun 10;23(30):3876-86. doi: 10.1016/j.vaccine.2005.03.005. Epub 2005 Apr 7.
Viruses and virus-induced lymphokines may have an important role in the pathogenesis of autoimmunity (Schattner A. Clin Immunol Immunopathol; 1994). The occurrence and significance of autoimmune manifestations after the administration of viral vaccines remain controversial.
Medline search of all relevant publications from 1966 through June 2004 with special emphasis on search of each individual autoimmune manifestation and vaccination, as well as specifically searching each viral vaccine for all potential autoimmune syndromes reported. All relevant publications were retrieved and critically analyzed.
The most frequently reported autoimmune manifestations for the various vaccinations, were: hepatitis A virus (HAV)--none; hepatitis B virus (HBV)--rheumatoid arthritis, reactive arthritis, vasculitis, encephalitis, neuropathy, thrombocytopenia; measles, mumps and rubella vaccine (MMR)--acute arthritis or arthralgia, chronic arthritis, thrombocytopenia; influenza--Guillain-Barre syndrome (GBS), vasculitis; polio--GBS; varicella--mainly neurological syndromes. Even these 'frequent' associations relate to a relatively small number of patients. Whenever controlled studies of autoimmunity following viral vaccines were undertaken, no evidence of an association was found.
Very few patients may develop some autoimmune diseases following viral vaccination (in particular - arthropathy, vasculitis, neurological dysfunction and thrombocytopenia). For the overwhelming majority of people, vaccines are safe and no evidence linking viral vaccines with type 1 diabetes, multiple sclerosis (MS) or inflammatory bowel disease can be found.
病毒及病毒诱导的淋巴因子可能在自身免疫性疾病的发病机制中起重要作用（沙特纳A.《临床免疫学与免疫病理学》；1994年）。接种病毒疫苗后自身免疫表现的发生情况及意义仍存在争议。
检索1966年至2004年6月期间的所有相关出版物，特别着重于检索每种个体自身免疫表现与疫苗接种情况，以及专门检索每种病毒疫苗所报告的所有潜在自身免疫综合征。检索并严格分析所有相关出版物。
各种疫苗接种最常报告的自身免疫表现为：甲型肝炎病毒（HAV）——无；乙型肝炎病毒（HBV）——类风湿关节炎、反应性关节炎、血管炎、脑炎、神经病变、血小板减少症；麻疹、腮腺炎和风疹疫苗（MMR）——急性关节炎或关节痛、慢性关节炎、血小板减少症；流感——格林-巴利综合征（GBS）、血管炎；脊髓灰质炎——GBS；水痘——主要为神经综合征。即使这些“常见”关联所涉及的患者数量也相对较少。每当对病毒疫苗接种后的自身免疫进行对照研究时，均未发现存在关联的证据。
极少数患者在接种病毒疫苗后可能会患上某些自身免疫性疾病（尤其是关节病、血管炎、神经功能障碍和血小板减少症）。对于绝大多数人而言，疫苗是安全的，未发现病毒疫苗与1型糖尿病、多发性硬化症（MS）或炎症性肠病存在关联的证据。
