Suppr超能文献

人乳头瘤病毒疫苗与原发性卵巢功能衰竭:佐剂诱发的自身免疫/炎症综合征的又一面。

Human papilloma virus vaccine and primary ovarian failure: another facet of the autoimmune/inflammatory syndrome induced by adjuvants.

机构信息

Zabludowicz Center for Autoimmune Diseases Sheba Medical Center, Tel-Hashomer, Israel; Rheumatology Unit, Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy.

出版信息

Am J Reprod Immunol. 2013 Oct;70(4):309-16. doi: 10.1111/aji.12151. Epub 2013 Jul 31.

Abstract

PROBLEM

Post-vaccination autoimmune phenomena are a major facet of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and different vaccines, including HPV, have been identified as possible causes.

METHOD OF STUDY

The medical history of three young women who presented with secondary amenorrhea following HPV vaccination was collected. Data regarding type of vaccine, number of vaccination, personal, clinical and serological features, as well as response to treatments were analyzed.

RESULTS

All three patients developed secondary amenorrhea following HPV vaccinations, which did not resolve upon treatment with hormone replacement therapies. In all three cases sexual development was normal and genetic screen revealed no pertinent abnormalities (i.e., Turner's syndrome, Fragile X test were all negative). Serological evaluations showed low levels of estradiol and increased FSH and LH and in two cases, specific auto-antibodies were detected (antiovarian and anti thyroid), suggesting that the HPV vaccine triggered an autoimmune response. Pelvic ultrasound did not reveal any abnormalities in any of the three cases. All three patients experienced a range of common non-specific post-vaccine symptoms including nausea, headache, sleep disturbances, arthralgia and a range of cognitive and psychiatric disturbances. According to these clinical features, a diagnosis of primary ovarian failure (POF) was determined which also fulfilled the required criteria for the ASIA syndrome.

CONCLUSION

We documented here the evidence of the potential of the HPV vaccine to trigger a life-disabling autoimmune condition. The increasing number of similar reports of post HPV vaccine-linked autoimmunity and the uncertainty of long-term clinical benefits of HPV vaccination are a matter of public health that warrants further rigorous inquiry.

摘要

问题

疫苗接种后的自身免疫现象是佐剂引起的自身免疫/炎症综合征(ASIA)的一个主要方面,已确定包括 HPV 在内的不同疫苗是其可能的原因。

方法

收集了三位年轻女性在 HPV 疫苗接种后出现继发性闭经的病史。分析了疫苗类型、接种次数、个人、临床和血清学特征以及对治疗的反应等数据。

结果

所有三位患者在 HPV 疫苗接种后均出现继发性闭经,且经激素替代疗法治疗后仍未缓解。在所有三例中,性发育正常,遗传筛查未发现相关异常(即特纳综合征、脆性 X 试验均为阴性)。血清学评估显示雌二醇水平降低,FSH 和 LH 升高,其中两例检测到特异性自身抗体(抗卵巢和抗甲状腺),提示 HPV 疫苗引发了自身免疫反应。盆腔超声在这三例中均未发现任何异常。所有三位患者均经历了一系列常见的非特异性疫苗接种后症状,包括恶心、头痛、睡眠障碍、关节痛以及一系列认知和精神障碍。根据这些临床特征,确定了原发性卵巢功能衰竭(POF)的诊断,该诊断也符合 ASIA 综合征的要求标准。

结论

我们在此记录了 HPV 疫苗引发致残性自身免疫疾病的潜在证据。越来越多的 HPV 疫苗接种后自身免疫相关的类似报告,以及 HPV 疫苗接种的长期临床获益的不确定性,是一个值得进一步严格调查的公共卫生问题。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验