Cohen A D, Shoenfeld Y
Department of Medicine B & Research, Sheba Medical Center, Tel-Hashomer, Israel.
J Autoimmun. 1996 Dec;9(6):699-703. doi: 10.1006/jaut.1996.0091.
The current review summarizes case reports attributing autoimmune diseases and phenomena to various vaccines and suggests potential mechanisms. It has to be emphasized that the demonstration of a temporal relationship does not necessarily attribute autoimmunity to a vaccine. The subject is complicated by the fact that one vaccine may cause more than one autoimmune phenomenon, and a particular immune process may be caused by more than one vaccine. Furthermore, vaccines differ in their pathogenic influence on the immune system. There is no doubt that the new recombinant hepatitis B virus vaccine is different from mumps, measles and rubella vaccines in its ability to trigger autoimmunity, probably by completely different mechanisms. The data summarized here suggest that some vaccines may in rare cases induce autoimmune disorders. The subject of the vaccine-autoimmunity relationship is still obscure; reports have been rare, no laboratory experimentation on this topic has been undertaken, and there are few animal models. For the time being no conclusions can be drawn. Since vaccines are an important prophylactic intervention, the risk-benefit ratio clearly leans towards the advantages of infectious disease prevention. Vaccination routines should not be changed in the healthy population or for patients with known autoimmune disorders. Laborious clinical and laboratory studies should be initiated in order to evaluate the new emerging subject of vaccine-induced autoimmunity.
本综述总结了将自身免疫性疾病和现象归因于各种疫苗的病例报告，并提出了潜在机制。必须强调的是，时间关系的证明并不一定将自身免疫归因于疫苗。该问题因以下事实而变得复杂：一种疫苗可能会引发不止一种自身免疫现象，而一种特定的免疫过程可能由不止一种疫苗引起。此外，疫苗对免疫系统的致病影响各不相同。毫无疑问，新型重组乙肝病毒疫苗在引发自身免疫的能力方面与腮腺炎、麻疹和风疹疫苗不同，其引发机制可能完全不同。此处总结的数据表明，某些疫苗在罕见情况下可能诱发自身免疫性疾病。疫苗与自身免疫关系的主题仍不明确；相关报告很少，尚未开展关于该主题的实验室实验，且动物模型也很少。目前无法得出结论。由于疫苗是一种重要的预防性干预措施，风险效益比显然倾向于预防传染病的优势。健康人群或已知自身免疫性疾病患者的疫苗接种程序不应改变。应启动详尽的临床和实验室研究，以评估新出现的疫苗诱导自身免疫这一主题。
