Suppr超能文献

2019冠状病毒病疫苗与自身免疫性血液系统疾病

COVID-19 Vaccines and Autoimmune Hematologic Disorders.

作者信息

Mingot-Castellano María Eva, Butta Nora, Canaro Mariana, Gómez Del Castillo Solano María Del Carmen, Sánchez-González Blanca, Jiménez-Bárcenas Reyes, Pascual-Izquierdo Cristina, Caballero-Navarro Gonzalo, Entrena Ureña Laura, José González-López Tomás

机构信息

Hematology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), 41013 Sevilla, Spain.

Hospital Universitario La Paz-IdiPAZ, 28046 Madrid, Spain.

出版信息

Vaccines (Basel). 2022 Jun 16;10(6):961. doi: 10.3390/vaccines10060961.

Abstract

Worldwide vaccination against SARS-CoV-2 has allowed the detection of hematologic autoimmune complications. Adverse events (AEs) of this nature had been previously observed in association with other vaccines. The underlying mechanisms are not totally understood, although mimicry between viral and self-antigens plays a relevant role. It is important to remark that, although the incidence of these AEs is extremely low, their evolution may lead to life-threatening scenarios if treatment is not readily initiated. Hematologic autoimmune AEs have been associated with both mRNA and adenoviral vector-based SARS-CoV-2 vaccines. The main reported entities are secondary immune thrombocytopenia, immune thrombotic thrombocytopenic purpura, autoimmune hemolytic anemia, Evans syndrome, and a newly described disorder, so-called vaccine-induced immune thrombotic thrombocytopenia (VITT). The hallmark of VITT is the presence of anti-platelet factor 4 autoantibodies able to trigger platelet activation. Patients with VITT present with thrombocytopenia and may develop thrombosis in unusual locations such as cerebral beds. The management of hematologic autoimmune AEs does not differ significantly from that of these disorders in a non-vaccine context, thus addressing autoantibody production and bleeding/thromboembolic risk. This means that clinicians must be aware of their distinctive signs in order to diagnose them and initiate treatment as soon as possible.

摘要

全球范围内针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的疫苗接种使得血液学自身免疫并发症得以被发现。这类不良事件(AE)此前曾在与其他疫苗相关的情况中被观察到。尽管病毒抗原与自身抗原之间的分子模拟起了相关作用,但其潜在机制尚未完全明确。需要着重指出的是,尽管这些不良事件的发生率极低,但如果不及时开始治疗,其进展可能会导致危及生命的情况。血液学自身免疫不良事件与基于信使核糖核酸(mRNA)和腺病毒载体的SARS-CoV-2疫苗均有关联。报告的主要病症有继发性免疫性血小板减少症、免疫性血栓性血小板减少性紫癜、自身免疫性溶血性贫血、伊文氏综合征,以及一种新描述的病症,即所谓的疫苗诱导的免疫性血栓性血小板减少症(VITT)。VITT的标志是存在能够触发血小板活化的抗血小板因子4自身抗体。VITT患者表现为血小板减少,且可能在诸如脑床等不寻常部位发生血栓形成。血液学自身免疫不良事件的管理与非疫苗背景下这些病症的管理并无显著差异,因此要应对自身抗体产生以及出血/血栓栓塞风险。这意味着临床医生必须知晓其独特体征以便进行诊断并尽快开始治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ecd/9231220/ee4ff10b4d8e/vaccines-10-00961-g001.jpg

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