Scarmozzino Rocco, Zanoni Giovanna, Arcolaci Alessandra, Ciccocioppo Rachele
Immunology Unit, Azienda Ospedaliera Universitaria Integrata Policlinico G.B. Rossi & University of Verona, 37134 Verona, Italy.
Gastroenterology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata Policlinico G.B. Rossi & University of Verona, 37134 Verona, Italy.
Vaccines (Basel). 2024 Nov 26;12(12):1328. doi: 10.3390/vaccines12121328.
Celiac disease (CD) is an autoimmune disorder caused by gluten intake in genetically predisposed individuals. This article provides an overview of the available data on the risks of infectious diseases and the mechanisms involved in CD, including a detailed analysis of vaccine efficacy, immunogenicity, and safety. The published articles were retrieved from the PubMed database using the terms "celiac disease", "efficacy", "hyposplenism", "immune response", "infections", "immunization", "immunogenicity", "safety", "vaccination", and "vaccine". CD can be associated with several autoimmune diseases, including selective immunoglobulin A deficiency (SIgAD), altered mucosal permeability, and hyposplenism. These conditions entail an increased risk of infections, which can be prevented by targeted vaccinations, although specific recommendations on immunization practices for subjects with CD have not been released. Regarding vaccinations, the immune response to the (HBV) vaccine can be impaired in patients with CD; therefore, proposed strategies to elicit and maintain protective specific antibody titers are summarized. For patients with conditions that put them at risk of infections, vaccinations against and other encapsulated bacteria should be recommended. Based on the available evidence, the vaccine offered to children could be useful in preventing CD in at-risk subjects. Overall, except for the HBV vaccine, vaccine efficacy in patients with CD is comparable to that in the general population, and no safety concerns have arisen.
乳糜泻（CD）是一种自身免疫性疾病，由遗传易感性个体摄入麸质引起。本文概述了关于传染病风险以及CD相关机制的现有数据，包括对疫苗效力、免疫原性和安全性的详细分析。使用“乳糜泻”“效力”“脾功能减退”“免疫反应”“感染”“免疫接种”“免疫原性”“安全性”“疫苗接种”和“疫苗”等术语从PubMed数据库检索已发表的文章。CD可与多种自身免疫性疾病相关，包括选择性免疫球蛋白A缺乏症（SIgAD）、黏膜通透性改变和脾功能减退。这些情况会增加感染风险，尽管尚未发布针对CD患者免疫接种实践的具体建议，但可通过针对性疫苗接种预防感染。关于疫苗接种，CD患者对乙肝疫苗（HBV）的免疫反应可能受损；因此，总结了引发和维持保护性特异性抗体滴度的建议策略。对于有感染风险的患者，应建议接种针对肺炎球菌和其他包膜细菌的疫苗。基于现有证据，向儿童提供的人乳头瘤病毒疫苗可能有助于预防高危人群的CD。总体而言，除乙肝疫苗外，CD患者的疫苗效力与普通人群相当，且未出现安全性问题。
