Molecular Mimicry of the Viral Spike in the SARS-CoV-2 Vaccine Possibly Triggers Transient Dysregulation of ACE2, Leading to Vascular and Coagulation Dysfunction Similar to SARS-CoV-2 Infection

Abstract

The benefits of SARS-CoV-2 spike mRNA vaccines are well known, including a significant decline in COVID-19 morbidity and a decrease in the mortality rate of SARS-CoV-2 infected persons. However, pharmacovigilance studies have revealed the existence of rare cases of cardiovascular complications after mass vaccination using such formulations. Cases of high blood pressure have also been reported but were rarely documented under perfectly controlled medical supervision. The press release of these warning signals triggered a huge debate over COVID-19 vaccines’ safety. Thereby, our attention was quickly focused on issues involving the risk of myocarditis, acute coronary syndrome, hypertension and thrombosis. Rare cases of undesirable post-vaccine pathophysiological phenomena should question us, especially when they occur in young subjects. They are more likely to occur with inappropriate use of mRNA vaccine (e.g., at the time when the immune response is already very active during a low-noise infection in the process of healing), leading to angiotensin II (Ang II) induced inflammation triggering tissue damage. Such harmful effects observed after the COVID-19 vaccine evoke a possible molecular mimicry of the viral spike transiently dysregulating angiotensin converting enzyme 2 (ACE2) function. Although the benefit/risk ratio of SARS-CoV-2 spike mRNA vaccine is very favorable, it seems reasonable to suggest medical surveillance to patients with a history of cardiovascular diseases who receive the COVID-19 vaccine.

Role Of Acute Vascular Distress Syndrome In The Development Of Multisystem Inflammatory Syndrome In Sars-Cov-2 And Modern Views On The Research And Treatment Of Critical Coronavirus

“…On the one hand, the benefits of SARS-CoV-2 spike mRNA vaccines are well known, including a significant decline in COVID-19 morbidity and a decrease in the mortality rate of SARS-CoV-2 infected persons. On the other hand, pharmacovigilance studies have revealed the existence of rare cases of cardiovascular complications after mass vaccination using such formulations as what we consider how Acute Vascular Distress Syndrome [126], which coincides with other data. The effect of SARS-CoV-2 Infection and BNT162b2 Vaccination on the mRNA Expression of Genes Associated with Angiogenesis contributes to the development of adverse cardiovascular effects [127].…”

Recovery from antibody-mediated biliary ductopenia and multiorgan inflammation after COVID-19 vaccination

“…For mRNA-based vaccines (e.g., mRNA-1273 SARS-CoV-2 vaccine [Moderna] and BNT162b2 mRNA Covid-19 vaccine [Pfizer/BioNTech]), potential biological mechanisms for an increased risk of immune-mediated diseases include mRNA’s intrinsic immunostimulatory properties. The vaccine’s end-protein (spike protein), by mimicking the behavior of the virus, can bind to ACE2, disrupt the body’s normal RAS, and cause endothelial injury 9 , 27 , 44 , 45 . Endothelial damage can trigger the development of anti-endothelial antibodies (e.g., anti-AT1R antibody) which can attack multiple organs 46 .…”

“…Endothelial damage can trigger the development of anti-endothelial antibodies (e.g., anti-AT1R antibody) which can attack multiple organs 46 . If there is a dysregulated, prolonged innate immune response, these changes may cause systemic inflammation and contribute to the development of autoimmune reactions and multiorgan injuries in some individuals after COVID-19 vaccination 9 , 27 , 44 , 45 . The role of anti-AT1R antibody was investigated in our case based on the resembling features of its involvement in both COVID-19-related multiorgan injury and AMR in solid organ transplantation.…”

COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign

“…We therefore refer readers to these papers [ 26 , 175 - 181 ]. The mechanisms of molecular mimicry, antigen cross-reactivity, pathogenic priming, viral reactivation, immune exhaustion, and other factors related to immune dysfunction all reinforce the biological plausibility for vaccine-induced pathogenesis of malignant and autoimmune diseases [ 26 , 182 - 185 ]. Both SARS-CoV-2 and the mRNA vaccines can trigger immune dysfunction along with a host of pathophysiological effects, including chronic inflammation, thrombogenesis, prion-related dysregulation, and endotheliitis-related tissue damage [ 180 ].…”