Published on February 4, 2010
Author: Hedi Orbach
Specialty: Immunology, Rheumatology, Microbiology, Infectious Diseases
Institution: Department of Medicine B, Wolfson Medical Center
Address: Holon, Israel
Author: Nancy Agmon-LevinSpecialty: Immunology, Rheumatology, Microbiology, Infectious Diseases
Institution: Center for Autoimmune Diseases & Department of Medicine B, Sheba Medical Center
Address: Ramat Gan, Israel
Author: Gisele Zandman-GoddardSpecialty: Immunology, Rheumatology, Microbiology, Infectious Diseases
Institution: Department of Medicine C, Wolfson Medical Center
Address: Holon, Israel
Institution: Sackler Faculty of Medicine, Tel-Aviv University
Address: Tel-Aviv, Israel
Abstract: Infectious agents contribute to the environmental factors involved in the development of autoimmune diseases possibly through molecular mimicry mechanisms. Hence, it is feasible that vaccinations may also contribute to the mosaic of autoimmunity. Evidence for the association of vaccinations and the development of these diseases is presented in this review. Infrequently reported post-vaccination autoimmune diseases include systemic lupus erythematosus, rheumatoid arthritis, inflammatory myopathies, multiple sclerosis, Guillain-Barré syndrome, and vasculitis. In addition, we will discuss macrophagic myofasciitis, aluminum containing vaccines, and the recent evidence for autoimmunity following human papilloma virus vaccine.
Systemic and organ-specific autoimmune diseases are known to develop following infectious triggers. Recently we have suggested that certain autoimmune diseases like systemic lupus erythematosus (SLE) may result due to specific viral agents. Furthermore, the spectrum of disease may be influenced by a certain microbial agent in the genetically predisposed individual (Zandman-Goddard et al., 2009).
Vaccines are a prototypic source for natural immune stimulation, but may be involved in pathogenic disease in the setting of aberrant immune system function. Possibly, the burden on the immune system resulting from simultaneous multiple vaccines and even the different types of vaccines may also be an overwhelming challenge in the autoimmune prone individual (Shoenfeld et al., 2008). In this review, we discuss the evidence for the development of autoimmune diseases following infections and vaccinations.
While vaccinations are generally safe, warranted and have virtually eradicated endemic diseases and probably lessened morbidity and mortality, a question arises regarding the evaluation of possible autoimmune phenomena in vaccinated individuals.
Reported post-vaccination autoimmune diseases in the adult include SLE, rheumatoid arthritis (RA), inflammatory myopathies, multiple sclerosis (MS), Guillain-Barré syndrome (GBS), and vasculitis. Evidence for the association of vaccinations and the development of these diseases is presented in this review. In addition, we will discuss macrophagic myofasciitis, post aluminum containing vaccines and the recent support for autoimmunity following human papilloma virus vaccine.