Battistella Melania, Carlino Cristiana, Dugo Valentina, Ponzo Patrizia, Franco Elisabetta
Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata.
Ig Sanita Pubbl. 2013 Sep-Oct;69(5):585-96.
Thanks to vaccinations the incidence of many seriously debilitating or life threatening diseases and the resulting infant mortality or disability have been drastically reduced. In populations, who are no more aware of the risk of these infections, the attitude of suspicion and fear towards the vaccinations is expanding and in some cases reaches a worldwide media coverage as was the case for the measles, mumps and rubella vaccine (MMR). In 1998, a British doctor, Andrew Wakefield, and co-authors, published in "Lancet" a study in which he suggested the existence of "a new variant of autism" associated with intestinal inflammation. He proposed the administration of the MMR vaccine as a possible. cause of the inflammatory process. The hypothesis suggested by Wakefield led to a drastic drop in vaccination coverage in the UK and to the failure to achieve adequate levels of immunization in many countries, with a consequent increase in the incidence of measles and its complications. Wakefield work stimulated a broad discussion in the scientific community and many studies conducted over the next few years contradicted the research results of the English physician. In 2004, journalist Brian Deer conducted an accurate investigation that revealed how the Wakefield research presented many not regular aspects and was performed with predominantly economic objectives. In 2010, Wakefield was expelled from the General Medical Council, while the "Lancet" retracted the paper. The scientific research conducted in recent years confirm the inconsistency of the relationship between MMR vaccine and autism. The possible association with other factors, such as autoimmune processes, hyperactivation of mast cells in the hypothalamus, use of paracetamol in genetically predisposed children are currently investigated.
多亏了疫苗接种,许多严重致残或危及生命的疾病的发病率以及由此导致的婴儿死亡率或残疾率都大幅降低。在那些不再意识到这些感染风险的人群中,对疫苗接种的怀疑和恐惧态度正在蔓延,在某些情况下甚至引起了全球媒体的关注,麻疹、腮腺炎和风疹疫苗(MMR)就是如此。1998年,英国医生安德鲁·韦克菲尔德及其合著者在《柳叶刀》杂志上发表了一项研究,他在研究中提出存在一种与肠道炎症相关的“自闭症新变体”。他认为接种MMR疫苗可能是炎症过程的一个原因。韦克菲尔德提出的这一假设导致英国的疫苗接种覆盖率急剧下降,许多国家也未能达到足够的免疫水平,麻疹及其并发症的发病率因此上升。韦克菲尔德的研究在科学界引发了广泛讨论,在接下来的几年里进行的许多研究都与这位英国医生的研究结果相矛盾。2004年,记者布莱恩·迪尔进行了一项精确调查,揭示了韦克菲尔德的研究存在许多不规范之处,而且主要是出于经济目的进行的。2010年,韦克菲尔德被英国医学总会除名,同时《柳叶刀》杂志撤回了那篇论文。近年来进行的科学研究证实了MMR疫苗与自闭症之间不存在关联。目前正在研究它与其他因素的可能关联,比如自身免疫过程、下丘脑肥大细胞的过度激活、在有遗传易感性的儿童中使用扑热息痛等。