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疫苗接种与自身免疫性疾病:预防对健康的不良影响在望吗?

Vaccination and autoimmune diseases: is prevention of adverse health effects on the horizon?

作者信息

Vadalà Maria, Poddighe Dimitri, Laurino Carmen, Palmieri Beniamino

机构信息

Department of General Surgery and Surgical Specialties, Medical School, Surgical Clinic, University of Modena and Reggio Emilia, Modena, Italy.

Network of the Second Opinion, Modena, MO Italy.

出版信息

EPMA J. 2017 Jul 20;8(3):295-311. doi: 10.1007/s13167-017-0101-y. eCollection 2017 Sep.

Abstract

Autoimmune diseases, including multiple sclerosis and type 1 diabetes mellitus, affect about 5% of the worldwide population. In the last decade, reports have accumulated on various autoimmune disorders, such as idiopathic thrombocytopenia purpura, myopericarditis, primary ovarian failure, and systemic lupus erythematosus (SLE), following vaccination. In this review, we discuss the possible underlying mechanisms of autoimmune reactions following vaccinations and review cases of autoimmune diseases that have been correlated with vaccination. Molecular mimicry and bystander activation are reported as possible mechanisms by which vaccines can cause autoimmune reactions. The individuals who might be susceptible to develop these reactions could be especially not only those with previous post-vaccination phenomena and those with allergies but also in individuals who are prone to develop autoimmune diseases, such as those with a family history of autoimmunity or with known autoantibodies, and the genetic predisposed individuals. Further research is encouraged into the direct associations between vaccines and autoimmune conditions, and the biological mechanisms behind them.

摘要

自身免疫性疾病,包括多发性硬化症和1型糖尿病,影响着全球约5%的人口。在过去十年中,关于接种疫苗后出现各种自身免疫性疾病的报告不断积累,如特发性血小板减少性紫癜、心肌心包炎、原发性卵巢功能衰竭和系统性红斑狼疮(SLE)。在本综述中,我们讨论了接种疫苗后自身免疫反应的可能潜在机制,并回顾了与接种疫苗相关的自身免疫性疾病病例。分子模拟和旁观者激活被报道为疫苗可引发自身免疫反应的可能机制。可能易发生这些反应的个体可能不仅包括那些有既往接种疫苗后现象和过敏的个体,还包括那些易患自身免疫性疾病的个体,如具有自身免疫家族史或已知自身抗体的个体以及具有遗传易感性的个体。鼓励对疫苗与自身免疫性疾病之间的直接关联及其背后的生物学机制进行进一步研究。

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