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Osman A, Almusa A, Ryad R, Sumbulyuksel B. Antisynthetase Syndrome Post Shingrix and Pneumovax Vaccinations, Possible Correlation. Cureus 2022; 14:e25085. [PMID: 35719791 PMCID: PMC9203250 DOI: 10.7759/cureus.25085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/06/2022] Open
Abstract
This is a case report of a patient who developed acute progressive shortness of breath that started two days following the administration of Shingrix and Pneumovax vaccinations. Eight days after the onset of his symptoms he was diagnosed with acute interstitial pneumonitis based on CT scan of the chest which later appeared to be consistent with the diagnosis of antisynthetase syndrome in light of findings consistent with mechanic's hands on examination, elevated Anti-Jo-1 antibody titers and aldolase on laboratory studies.
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Colafrancesco S, Perricone C, Priori R, Valesini G, Shoenfeld Y. Sjögren's syndrome: another facet of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). J Autoimmun 2014; 51:10-6. [PMID: 24774584 DOI: 10.1016/j.jaut.2014.03.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 03/21/2014] [Indexed: 01/26/2023]
Abstract
Recently, a new syndrome, namely the "Autoimmune/inflammatory syndrome induced by adjuvants" (ASIA) has been defined. In this syndrome different conditions characterized by common signs and symptoms and induced by the presence of an adjuvant are included. The adjuvant is a substance capable of boosting the immune response and of acting as a trigger in the development of autoimmune diseases. Post-vaccination autoimmune phenomena represent a major issue of ASIA. Indeed, despite vaccines represent a mainstay in the improvement of human health, several of these have been implicated as a potential trigger for autoimmune diseases. Sjogren's Syndrome (SjS) is a systemic chronic autoimmune inflammatory disease characterized by the presence of an inflammatory involvement of exocrine glands accompanied by systemic manifestations. Own to the straight association between infectious agents exposure (mainly viruses) and sicca syndrome development, the possible link between vaccine and SjS is not surprising. Indeed, a few cases of SjS following vaccine delivery have been reported. At the same extent, the induction of SjS following silicone exposure has been described too. Thus, the aim of this review was to focus on SjS and its possible development following vaccine or silicone exposure in order to define another possible facet of the ASIA syndrome.
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Affiliation(s)
- S Colafrancesco
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome, Italy; The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - C Perricone
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome, Italy; The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Priori
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome, Italy
| | - G Valesini
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome, Italy
| | - Y Shoenfeld
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Israel.
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Perricone C, Colafrancesco S, Mazor RD, Soriano A, Agmon-Levin N, Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun 2013; 47:1-16. [PMID: 24238833 DOI: 10.1016/j.jaut.2013.10.004] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 10/21/2013] [Indexed: 12/23/2022]
Abstract
In 2011 a new syndrome termed 'ASIA Autoimmune/Inflammatory Syndrome Induced by Adjuvants' was defined pointing to summarize for the first time the spectrum of immune-mediated diseases triggered by an adjuvant stimulus such as chronic exposure to silicone, tetramethylpentadecane, pristane, aluminum and other adjuvants, as well as infectious components, that also may have an adjuvant effect. All these environmental factors have been found to induce autoimmunity by themselves both in animal models and in humans: for instance, silicone was associated with siliconosis, aluminum hydroxide with post-vaccination phenomena and macrophagic myofasciitis syndrome. Several mechanisms have been hypothesized to be involved in the onset of adjuvant-induced autoimmunity; a genetic favorable background plays a key role in the appearance on such vaccine-related diseases and also justifies the rarity of these phenomena. This paper will focus on protean facets which are part of ASIA, focusing on the roles and mechanisms of action of different adjuvants which lead to the autoimmune/inflammatory response. The data herein illustrate the critical role of environmental factors in the induction of autoimmunity. Indeed, it is the interplay of genetic susceptibility and environment that is the major player for the initiation of breach of tolerance.
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Affiliation(s)
- Carlo Perricone
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
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Unraveling the soul of autoimmune diseases: pathogenesis, diagnosis and treatment adding dowels to the puzzle. Immunol Res 2013; 56:200-5. [DOI: 10.1007/s12026-013-8429-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Martínez-Sernández V, Figueiras A. Central nervous system demyelinating diseases and recombinant hepatitis B vaccination: a critical systematic review of scientific production. J Neurol 2012; 260:1951-9. [PMID: 23086181 DOI: 10.1007/s00415-012-6716-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/10/2012] [Accepted: 10/11/2012] [Indexed: 12/20/2022]
Abstract
The etiology of multiple sclerosis has not yet been fully described. A potential link between the recombinant hepatitis B vaccine and an increased risk of onset or exacerbation of multiple sclerosis emerged in the mid-1990s, leading to several spontaneous reports and studies investigating this association. We conducted a critical systematic review aimed at assessing whether hepatitis B vaccination increases the risk of onset or relapse of multiple sclerosis and other central nervous system demyelinating diseases. MEDLINE and EMBASE were used as data sources, and the search covered the period between 1981 and 2011. Twelve references met the inclusion criteria. No significant increased risk of onset or relapse of the diseases considered was associated with hepatitis B vaccination, except in one study. Most studies included in this review displayed methodological limitations and heterogeneity among them, which rendered it impossible to draw robust conclusions about the safety of hepatitis B vaccination in healthy subjects and patients with multiple sclerosis. Therefore, on the basis of current data there is no need to modify the vaccination recommendations; however, there is a need to improve the quality of observational studies with emphasis on certain considerations that are discussed in this review.
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Affiliation(s)
- V Martínez-Sernández
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain.
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Dimitrijević L, Živković I, Stojanović M, Petrušić V, Živančević-Simonović S. Vaccine model of antiphospholipid syndrome induced by tetanus vaccine. Lupus 2012; 21:195-202. [DOI: 10.1177/0961203311429816] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Successful induction of antiphospholipid syndrome (APS) in two different non-autoimmune prone mouse strains, BALB/c and C57BL/6, was achieved by tetanus toxoid (TTd) hyperimmunization using different adjuvants (glycerol or aluminium hydroxide), and different adjuvant pretreatments (glycerol or Complete Freund’s Adjuvant (CFA)). APS had different manifestations of reproductive pathology in BALB/c and C57BL/6 mice: fetal resorption (as a consequence of extreme T-cell activation obtained in the course of pretreatment), and lowering of fecundity (as a consequence of polyclonal B-cell stimulation), respectively. In BALB/c mice fetal resorption coincided with glycerol and CFA pretreatments, while in C57BL/6 mice lowering of fecundity was most obvious in CFA-pretreated mice immunized with TTd in aluminium hydroxide. Both molecular mimicry and polyclonal B-cell activation occur in APS induction, with molecular mimicry effects being dominant in BALB/c mice, and polyclonal cell activation being dominant in C57BL/6 mice. Confirmation of molecular mimicry effects, which in the condition of T-cell stimulation generated fetal resorptions in the BALB/c strain, was achieved by passive infusion of monoclonal antibody (MoAb) T-26 specific for TTd and anti-β2-glycoprotein I obtained after TTd hyperimunization. High polyclonal B-cell activation in C57BL/6 mice prevented fetal resorption but induced fecundity lowering, as was the case in passive administration of MoAb T-26 in this mouse strain. Passive infusion of anti-idiotypic MoAb Y7 into C57BL/6 mice induced fetal resorptions and confirmed the above suggestion on the protective role of polyclonal B-cell stimulation in fetal resorptions.
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Affiliation(s)
- L Dimitrijević
- Institute of Virology, Vaccines and Sera – Torlak, Department of Research and Development, Belgrade, Serbia
| | - I Živković
- Institute of Virology, Vaccines and Sera – Torlak, Department of Research and Development, Belgrade, Serbia
| | - M Stojanović
- Institute of Virology, Vaccines and Sera – Torlak, Department of Research and Development, Belgrade, Serbia
| | - V Petrušić
- Institute of Virology, Vaccines and Sera – Torlak, Department of Research and Development, Belgrade, Serbia
| | - S Živančević-Simonović
- Medical Faculty, University of Kragujevac, Institute of Pathophysiology, Kragujevac, Serbia
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Barabas AZ, Cole CD, Barabas AD, Graeff RM, Lafreniere R, Weir DM. Correcting autoimmune anomalies in autoimmune disorders by immunological means, employing the modified vaccination technique. Autoimmun Rev 2009; 8:552-7. [DOI: 10.1016/j.autrev.2009.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Accepted: 01/21/2009] [Indexed: 01/18/2023]
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Stojanović M, Živković I, Inić-Kanada A, Petrušić V, Mićić M, Dimitrijević L. The context of tetanus toxoid application influences the outcome of antigen-specific and self-directed humoral immune response. Microbiol Immunol 2009; 53:89-100. [DOI: 10.1111/j.1348-0421.2008.00094.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Altman A, Szyper-Kravitz M, Shoenfeld Y. HBV vaccine and dermatomyositis: is there an association? Rheumatol Int 2007; 28:609-12. [PMID: 18034245 DOI: 10.1007/s00296-007-0485-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 10/18/2007] [Indexed: 12/12/2022]
Abstract
The etiology of dermatomyositis is unknown, but immune mechanisms play an important role. Several dermatological manifestations have been reported among carriers of hepatitis B surface antigen, and after vaccination with the HBV vaccine. Almost all the skin reactions described were peculiar skin eruptions suggestive of an immune complex reaction. Some authors described the occurrence of dermatomyositis after BCG and influenza vaccination. We report a case of a 6-year-old child, who was vaccinated for hepatitis B virus and developed a flu-like disease accompanied by a skin rash, which had the typical features of dermatomyositis. The association of vaccination with autoimmunity is discussed.
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Affiliation(s)
- Arie Altman
- Center for Autoimmune Diseases and Department of Medicine B, Sheba Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract
Multiple sclerosis (MS) is used as the best example to illustrate the interplay between genetic endowment and environmental effects. The former is widely considered as being the more important one, although there is mounting evidence that environmental factors influence genetic predisposition. The vast majority of environmental epidemiological studies have failed for two major reasons: they have lacked biological plausibility, and they have not considered possible environmental factors operative during the putative period of acquisition of the disease. Lack of diagnostic precision in distinguishing among the inflammatory demyelinating diseases has caused confusion. The role of infectious agents remains controversial: there is little evidence in favor of MS resulting from a specific infection, but the effect of viral infections and vaccinations on the immune system of a genetically vulnerable person remains unresolved.
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Affiliation(s)
- Charles M Poser
- Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston MA 02118, USA.
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Tarján P, Sipka S, Lakos G, Kiss E, Ujj G, Szegedi G. Influenza vaccination and the production of anti-phospholipid antibodies in patients with systemic lupus erythematosus. Scand J Rheumatol 2006; 35:241-3. [PMID: 16766374 DOI: 10.1080/03009740500474552] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bogdanos DP, Smith H, Ma Y, Baum H, Mieli-Vergani G, Vergani D. A study of molecular mimicry and immunological cross-reactivity between hepatitis B surface antigen and myelin mimics. Clin Dev Immunol 2005; 12:217-24. [PMID: 16295528 PMCID: PMC2275415 DOI: 10.1080/17402520500285247] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
On the basis of the reported association between hepatitis B vaccination
(HBvacc) and autoimmune demyelinating complications such as multiple sclerosis
(MS), we have looked for aminoacid similarities between the small hepatitis
B virus surface antigen (SHBsAg), and the MS-autoantigens myelin basic protein
(MBP) and myelin oligodendrocyte glycoprotein (MOG) that could serve as targets
of immunological cross-reactivity. Twenty-mer peptides spanning 4 SHBsAg/MOG
and 1 SHBsAg/MBP mimicking pairs, were constructed and tested by ELISA as
targets of cross-reactive responses. A total of 147 samples from 58 adults were
collected before HBvacc (58/58), and post-HBvacc (48/58 before the second and
41/58 before the third boost). Eighty-seven sera from anti-SHBsAg antibody
negative patients with various diseases were tested as pathological controls.
Reactivity to at least one of the SHBsAg peptides was found in 8 (14%)
pre-HBvacc subjects; amongst the remaining 50, reactivity to at least one of the
SHBsAg peptides appeared in 47 (94%) post-HBvacc. Reactivity to at least one
of the MOG mimics was present in 4 (8%) pre-HBvacc and in 30 (60%)
post-HBvacc (p < 0.001). Overall 30/50 (60%) vaccinees had SHBsAg/MOG
double reactivity on at least one occasion compared to none before-vaccination
and in 2 (2%) of the pathological controls (p < 0.001 for both). SHBsAg/MOG
double reactivity was cross-reactive as confirmed by inhibition studies. At 6 months
post-vaccination, 3 of the 4 anti-MOG reactive cases before vaccination and 7
of the 24 (29%) of the anti-MOG reactive cases at 3 months post-vaccination had
lost their reactivity to MOG5-24. There was no reactivity to the SHBsAg/MBP
mimics. None of the vaccinees reported symptoms of demyelinating disorders. In
view of the observed SHBsAg/MOG cross-reactivity, the vaccine's possible role as
an immunomodulator of viral/self cross-reactivity must be further investigated.
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Comenge Y, Girard M. Multiple sclerosis and hepatitis B vaccination: adding the credibility of molecular biology to an unusual level of clinical and epidemiological evidence. Med Hypotheses 2005; 66:84-6. [PMID: 16176857 DOI: 10.1016/j.mehy.2005.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Accepted: 08/01/2005] [Indexed: 11/26/2022]
Abstract
In spite of a huge number of reports of severe hazards after injection of hepatitis B vaccine (HBV), the issue is regularly raised that no mechanism is available for the development of central demyelinating disorders such as multiple sclerosis (MS). A number of convergent facts, however, suggests that the manufacturing process could introduce HBV polymerase as a contaminant, and then trigger an auto-immune process against myelin in some vaccinated subjects. Of great significance, this hypothesis is likely to give the missing link to account for the considerable body of clinical and epidemiological evidence documenting that, for a drug used with a preventive purpose, HBV has an unusual potential to induce central neurological disorders amongst others unwanted side-effects.
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