Rheumatology Department, National Institute of Cardiology, Mexico.
Rheumatology Department, National Institute of Cardiology, Mexico.
Autoimmun Rev. 2020 Sep;19(9):102603. doi: 10.1016/j.autrev.2020.102603. Epub 2020 Jul 10.
More than one-fourth of all Persian gulf war coalition soldiers remain seriously ill. Several epidemiological studies suggest a link between multiple vaccinations at the time of the military operation and the illness development. Macrophagic Myofasciitis and post-HPV vaccination syndrome are two newer controversial vaccine-related disabling ailments.
All original epidemiological studies (n = 11) found a positive association between vaccination and gulf war illness development. Chronic fatigue, widespread pain and cognitive impairment characterize the three syndromes under discussion. Anti-adrenergic receptor antibodies, dysautonomia and small fiber neuropathy have been recently described in patients with post-HPV vaccination syndrome.
post-HPV vaccination syndrome, Macrophagic Myofasciitis, and gulf war illness analogy suggests that some vaccines or multiple vaccinations in a very short period of time may induce, in susceptible individuals, chronic pain, fatigue and dyscognition. Vaccine-induced autoimmune dysautonomia is hypothesized as the common pathogenetic mechanism for this symptom cluster. Further research on the presence of small fiber neuropathy, adrenergic receptor antibodies, and abnormal autonomic function tests in the three syndromes under discussion may help to elucidate this hypothesis.
超过四分之一的波斯湾战争联军士兵仍患有重病。几项流行病学研究表明,在军事行动时接种多种疫苗与疾病的发展之间存在关联。巨噬细胞肌筋膜痛和 HPV 疫苗接种后综合征是两种较新的有争议的与疫苗相关的致残疾病。
1)系统审查所有调查疫苗与海湾战争病之间关联的原始文章,2)讨论海湾战争病、巨噬细胞肌筋膜痛和 HPV 疫苗接种后综合征的临床相似性,3)讨论为 HPV 疫苗接种后综合征提出的新出现的发病机制,这些机制可能与海湾战争病和巨噬细胞肌筋膜痛也有关。
所有原始的流行病学研究(n=11)都发现疫苗接种与海湾战争病的发展之间存在正相关。慢性疲劳、广泛疼痛和认知障碍是正在讨论的三种综合征的特征。最近在 HPV 疫苗接种后综合征患者中描述了抗肾上腺素能受体抗体、自主神经功能障碍和小纤维神经病。
HPV 疫苗接种后综合征、巨噬细胞肌筋膜痛和海湾战争病的相似性表明,某些疫苗或在很短的时间内接种多种疫苗可能会在易感个体中引起慢性疼痛、疲劳和认知障碍。疫苗诱导的自身免疫性自主神经功能障碍被假设为这种症状群的共同发病机制。对正在讨论的三种综合征中小纤维神经病、肾上腺素能受体抗体和异常自主功能测试的进一步研究可能有助于阐明这一假说。