Leukocytoclastic vasculitis flare following the COVID‐19 vaccine

Cohen, Stephanie R.; Prussick, Lisa; Kahn, Jared S.; Gao, David X.; Radfar, Arash; Rosmarin, David

doi:10.1111/ijd.15623

Cited by 97 publications

(109 citation statements)

References 3 publications

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“…Our study provides the arguments that the spike protein can induce changes in the normal physiology of the brain ECs. Moreover, several reports have shown the adverse effects of vaccines, including anaphylactic shock, which could be related to vasculopathy [51,52]. Moreover, a report describing neurological signs, including Guillain-Barre syndrome (GBS), a rare type of autoimmune disease attacking myelin induced by vaccine administration, potentially supports our hypothesis [53].…”

Section: Discussionsupporting

confidence: 74%

Spike Proteins of SARS-CoV-2 Induce Pathological Changes in Molecular Delivery and Metabolic Function in the Brain Endothelial Cells

Kim

Jeon

Kim

et al. 2021

Viruses

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19), is currently infecting millions of people worldwide and is causing drastic changes in people’s lives. Recent studies have shown that neurological symptoms are a major issue for people infected with SARS-CoV-2. However, the mechanism through which the pathological effects emerge is still unclear. Brain endothelial cells (ECs), one of the components of the blood–brain barrier, are a major hurdle for the entry of pathogenic or infectious agents into the brain. They strongly express angiotensin converting enzyme 2 (ACE2) for its normal physiological function, which is also well-known to be an opportunistic receptor for SARS-CoV-2 spike protein, facilitating their entry into host cells. First, we identified rapid internalization of the receptor-binding domain (RBD) S1 domain (S1) and active trimer (Trimer) of SARS-CoV-2 spike protein through ACE2 in brain ECs. Moreover, internalized S1 increased Rab5, an early endosomal marker while Trimer decreased Rab5 in the brain ECs. Similarly, the permeability of transferrin and dextran was increased in S1 treatment but decreased in Trimer, respectively. Furthermore, S1 and Trimer both induced mitochondrial damage including functional deficits in mitochondrial respiration. Overall, this study shows that SARS-CoV-2 itself has toxic effects on the brain ECs including defective molecular delivery and metabolic function, suggesting a potential pathological mechanism to induce neurological signs in the brain.

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Section: Discussionsupporting

confidence: 74%

Spike Proteins of SARS-CoV-2 Induce Pathological Changes in Molecular Delivery and Metabolic Function in the Brain Endothelial Cells

Kim

Jeon

Kim

et al. 2021

Viruses

View full text Add to dashboard Cite

show abstract

“…Additionally, vaccine-derived trauma and degradation of the extracellular matrix may initiate a fibrogenic inflammatory response, promoting connective tissue diseases such as circumscribed scleroderma (morphea) [35]. Other effects of vaccines may include immune complex formation, which is the etiopatho-logical trigger of leukocytoclastic vasculitis of cutaneous capillaries and venules [39]. The spectrum of cutaneous vasculitides in the course of COVID-19 vaccines has been reviewed recently by another group, and will not be further discussed herein [40].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

et al. 2021

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(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.

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“…Vasculitis after COVID-19 vaccination has been reported in different dermatological areas [ 5 , 6 ]. A recent study demonstrated that the frequencies of vasculitis within approximately two weeks after the first dose of Pfizer (New York, NY, USA)-BioNTech (Mainz, Germany) (BNT162b2) and Moderna (mRNA-1273) vaccine were 2.9% and 0.7%, respectively [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Intracerebral hemorrhage due to vasculitis following COVID-19 vaccination: a case report

et al. 2021

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Leukocytoclastic vasculitis flare following the COVID‐19 vaccine

Cited by 97 publications

References 3 publications

Spike Proteins of SARS-CoV-2 Induce Pathological Changes in Molecular Delivery and Metabolic Function in the Brain Endothelial Cells

Spike Proteins of SARS-CoV-2 Induce Pathological Changes in Molecular Delivery and Metabolic Function in the Brain Endothelial Cells

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

Intracerebral hemorrhage due to vasculitis following COVID-19 vaccination: a case report

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