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: J Autoimmun 2000 Feb;14(1):1-10 |
Vaccination and autoimmunity-'vaccinosis': a
dangerous liaison?
Shoenfeld Y, Aron-Maor A.
Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel.
shoefel@post.tau.ac.il
The question of a connection between vaccination and autoimmune illness (or
phenomena) is surrounded by controversy. A heated debate is going on regarding
the causality between vaccines, such as measles and anti-hepatitis B virus
(HBV), and multiple sclerosis (MS). Brain antibodies as well as clinical symptoms
have been found in patients vaccinated against those diseases. Other autoimmune
illnesses have been associated with vaccinations. Tetanus toxoid, influenza
vaccines, polio vaccine, and others, have been related to phenomena ranging
from autoantibodies production to full-blown illness (such as rheumatoid
arthritis (RA)). Conflicting data exists regarding also the connection between
autism and vaccination with measles vaccine.So far only one controlled study of
an experimental animal model has been published, in which the possible causal
relation between vaccines and autoimmune findings has been examined: in healthy
puppies immunized with a variety of commonly given vaccines, a variety of
autoantibodies have been documented but no frank autoimmune illness was
recorded. The findings could also represent a polyclonal activation (adjuvant
reaction). The mechanism (or mechanisms) of autoimmune reactions following
immunization has not yet been elucidated. One of the possibilities is molecular
mimicry; when a structural similarity exists between some viral antigen (or
other component of the vaccine) and a self-antigen. This similarity may be the
trigger to the autoimmune reaction. Other possible mechanisms are
discussed.Even though the data regarding the relation between vaccination and
autoimmune disease is conflicting, it seems that some autoimmune phenomena are
clearly related to immunization (e.g. Guillain-Barre syndrome).The issue of the
risk of vaccination remains a philosophical one, since to date the advantages
of this policy have not been refuted, while the risk for autoimmune disease has
not been irrevocably proved. We discuss the pros and cons of this issue
(although the temporal relationship (i.e. always 2-3 months following
immunization) is impressive). Copyright 2000 Academic Press.
Publication Types:
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Review
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Review, tutorial
PMID: 10648110 [PubMed - indexed for MEDLINE]