After immunization of four calves with a live modified Mycobacterium paratuberculosis vaccine the course of the humoral and cell mediated immune reactions was studied during a 2-year clinical investigation. Furthermore, the possibility of shedding of the vaccine strain and the influence of the vaccination on the tuberculin skin test was determined. In addition to standard procedures recently developed diagnostic methods (antibody enzyme-linked immunosorbent assay, interferon-gamma test, polymerase chain reaction) were used. A cell-mediated immune reaction, reflected in an increased, specifically induced, interferon-gamma production developed much earlier (1-2 weeks post-immunization) than humoral immunity (8-16 weeks post-gamma immunization). While the increase in antibody titres was transient, declining to extremely low levels 48-60 weeks post-immunization, cell-mediated immunity remained detectable until the end of the investigation. Spread of the vaccine strain into the body and shedding were never detected during the whole course of the study except for one colon site in one calf. As late as 2 years after vaccine application positive or doubtful skin reactions against M. bovis purified protein derivative were measured, reflecting possible interference of the immunization with the diagnosis of bovine tuberculosis. At the end of the investigation, a positive cell-mediated immune reaction was detected the control animal although clinical, pathological and bacteriological examinations gave no indication for a mycobacterial infection.
Correspondence urticarial and morbilliform eruptions. Less frequently seen reactions included chilblains, cosmetic filler reactions, herpes zoster or herpes simplex flares, and pityriasis rosea-like reactions. Only two patients had cutaneous vasculitis. Lupus-like skin lesions or lupus deterioration were not reported. 7 Strong agreement exists that all patients with autoimmune rheumatic diseases should be vaccinated against COVID-19. However, SARS-CoV-2 vaccination should be considered as a potential trigger of disease flares, especially in individuals with certain ANA constellations (e.g. anti-Ro/SSA and anti-La/SSB antibodies) predisposing for CLE.
Dear Editor,The recent approval of highly effective prophylactic vaccines against COVID-19 is a monumental step in the global fight against the ongoing SARS-CoV-2 pandemic. Two types of SARS-CoV-2 vaccines are currently used, messenger-RNA (mRNA) vaccines and recombinant adenoviral (AdV) vector vaccines. 1 Both of them encode the production of the SARS-CoV-2 spike protein, which is the primary target for neutralizing antibodies. We report a case of subacute cutaneous lupus erythematosus (SCLE) that transitioned into systemic lupus erythematosus (SLE) following AdV-vaccination with AZD1222.A 62-year-old woman presented with a generalized morbilliform exanthema and new onset of fatigue and musculoskeletal pain (Fig. 1). Six months before the first visit to our department, the patient had experienced erythematosquamous papules and plaques symmetrically located in the sun-exposed areas (chest, upper back, lower arms, and dorsal hands). Laboratory investigations found a normal blood cell count and serum chemistry, but increased titres for antinuclear antibodies (1 : 320; normal <1 : 160) and positivity for anti-Ro/SSA(60) antibodies. All other extractable nuclear antigens were unremarkable. Further
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