Zabludowicz Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel.
Curr Opin Rheumatol. 2010 Jul;22(4):431-6. doi: 10.1097/BOR.0b013e32833a43c3.
Vaccines remain an effective yet controversial method for preventing infectious diseases like those caused by human papillomavirus (HPV) and pandemic influenza (H1N1). However, reports of postvaccination serious adverse events such as autoimmunity, although rare, have caused great concerns among the general public. We aimed to summarize the recent knowledge regarding such interactions, mainly focusing on these new vaccines.
Autoimmune phenomena have been associated with specific vaccines, and mechanisms for how this occurs have been elucidated for different vaccine components like the infectious antigen and adjuvant. New vaccines that include infrequently used or new adjuvants have been introduced for both HPV and the H1N1-pandemic influenza. Additionally, two formulations have been approved for use against HPV, and various formulations for the H1N1 influenza vaccine. Whereas preliminary studies are successful, early and late postimmunization events and differences between reagents must be followed closely, especially during mass immunization programs.
As more diseases are found to be preventable through vaccination, it is of great importance to design better, more effective and better tolerated vaccines. This goal may be achieved utilizing improved vaccine components and a postmarketing system that may allow detection of rare postvaccination phenomena.
目的综述:疫苗仍然是预防传染病的有效手段,但也存在争议,如人乳头瘤病毒(HPV)和大流行性流感(H1N1)。然而,疫苗接种后出现自身免疫等严重不良事件的报道虽然罕见,但引起了公众的极大关注。我们旨在总结最近关于这些相互作用的知识,主要集中在这些新疫苗上。
最新发现:自身免疫现象与特定疫苗有关,并且已经阐明了不同疫苗成分(如感染性抗原和佐剂)发生这种情况的机制。针对 HPV 和大流行性流感 H1N1,已经引入了包括不常用或新佐剂的新型疫苗。此外,有两种 HPV 疫苗制剂获得批准,也有多种 H1N1 流感疫苗制剂。虽然初步研究取得了成功,但必须密切关注早期和晚期免疫后事件以及试剂之间的差异,特别是在大规模免疫接种计划期间。
总结:随着越来越多的疾病被发现可以通过疫苗预防,设计更好、更有效和更耐受的疫苗非常重要。这一目标可以通过利用改进的疫苗成分和上市后系统来实现,该系统可以检测到罕见的疫苗接种后现象。