Postvaccination graft dysfunction/aplastic anemia relapse with massive clonal expansion of autologous CD8+ lymphocytes

Ritz, Caitlin; Meng, Wenzhao; Stanley, Natasha; Baroja, Miren L.; Xu, Chong; Yan, Patrick; Huang, Alexander C.; Hausler, Ryan; Nicholas, Peter; Fan, Jian-Meng; Lieberman, David; Carreño, Beatriz M.; Prak, Eline T. Luning; Olson, Timothy S.; Babushok, Daria V.

doi:10.1182/bloodadvances.2019000853

Cited by 17 publications

(20 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The measurement of vaccine antibody titers before and after allogeneic HSCT may provide a clue to the pathogenesis of vaccine-related autoimmune diseases. The clonal expansion of effector T cells was also reported to occur following vaccination [ 20 ]. To understand the link between COVID-19 vaccination and the development of AA, the following needs to be examined: the exploration of autoantibodies against stem cells, the role for molecular mimicry between mRNA vaccine encoded antigens and stem cells, and T-cell subset dynamics after vaccination.…”

Section: Discussionmentioning

confidence: 99%

Severe aplastic anemia after COVID-19 mRNA vaccination: Causality or coincidence?

Tabata

Hosoi

Murata

et al. 2022

Journal of Autoimmunity

View full text Add to dashboard Cite

The development of various autoimmune diseases has been reported after COVID-19 infections or vaccinations. However, no method for assessing the relationships between vaccines and the development of autoimmune diseases has been established. Aplastic anemia (AA) is an immune-mediated bone marrow failure syndrome. We report a case of severe AA that arose after the administration of a COVID-19 vaccine (the Pfizer-BioNTech mRNA vaccine), which was treated with allogeneic hematopoietic stem cell transplantation (HSCT). In this patient, antibodies against the SARS-CoV-2 spike protein were detected both before and after the HSCT. After the patient's hematopoietic stem cells were replaced through HSCT, his AA improved despite the presence of anti-SARS-CoV-2 antibodies. In this case, antibodies derived from the COVID-19 vaccine may not have been directly involved in the development of AA. This case suggests that the measurement of vaccine antibody titers before and after allogeneic HSCT may provide clues to the pathogenesis of vaccine-related autoimmune diseases. Although causality was not proven in this case, further evaluations are warranted to assess the associations between vaccines and AA.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe aplastic anemia after COVID-19 mRNA vaccination: Causality or coincidence?

Tabata

Hosoi

Murata

et al. 2022

Journal of Autoimmunity

View full text Add to dashboard Cite

show abstract

“…However, the clinical outcome seems highly unpredictable, as the other reported patients post‐HBV, H1N1 influenza, and varicella‐zoster virus vaccines were both paediatric or adults experiencing either transient disease or severe refractory AA requiring bone marrow transplant. 9 , 10 , 11 , 12 , 13 , 14 , 15 …”

mentioning

confidence: 99%

A case of severe aplastic anaemia after SARS‐CoV‐2 vaccination

et al. 2021

View full text Add to dashboard Cite

“…Previous studies on the pathogenesis of SAA have extended upstream to the activation of mDC, but the etiologic trigger for mDC is still not clear. Some cases of SAA onset or relapse after virus infection or vaccination, 5 which make many scholars believe that antigen stimulation may be the cause of mDC activation and the resulting immune response. FR Schuster, et al 6 preformed a spectratype analysis of TCR V‐beta pattern for bone marrow lymphocytes in SAA patients, which showed that CTL expanded with oligoclonal characteristics, and IST treatment can restore the diversity of TCR, suggesting that CTL expansion in patients with SAA is mediated by antigen.…”

Section: Discussionmentioning

confidence: 99%

Myeloid dendritic cells in severe aplastic anemia patients exhibit stronger phagocytosis

Sun

Liu

et al. 2021

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background A deeper understanding of the pathogenesis of severe aplastic anemia (SAA) is urgently warranted to achieve better therapeutic effects. The objective of this study was to investigate the phagocytosis of myeloid dendritic cell (mDC) in SAA patients. Methods Myeloid dendritic cells were induced in vitro from bone marrow mononuclear cells from 26 SAA patients and 12 normal controls (HCs). The phagocytosis of mDCs was detected by flow cytometry using FITC‐Dextran (40KD), and its correlation with the immune status and severity of the disease was analyzed. Results The phagocytosis of mDC from untreated SAA patients was significantly stronger than that from complete remission group and HC group ( p < 0.05). There was no statistical difference between the latter two groups ( p > 0.05). The phagocytosis of mDC from SAA patients correlated positively with the concentration of interleukin (IL)‐2 ( r = 0.389, p < 0.05), and IL‐4 ( r = 0.556, p < 0.05), negatively with CD4 + /CD8 + ratio ( r = −0.421, p < 0.05). It also had negative correlations with the level of hemoglobin ( r = −0.393, p < 0.05), white blood cell ( r = −0.436, p < 0.05), platelet ( r = −0.431, p < 0.05), and reticulocyte ( r = −0.447, p < 0.05). The phagocytosis of mDC does not correlate with the response to IST. Conclusions The increased phagocytosis of mDC in untreated SAA patients may contribute to abnormal activation of T helper (Th) and subsequent cytotoxic T lymphocyte (CTL) activation in these patients. It may be involved in the immune pathogenesis of SAA.

show abstract

Postvaccination graft dysfunction/aplastic anemia relapse with massive clonal expansion of autologous CD8+ lymphocytes

Abstract: Key Points Acquired aplastic anemia is a T-cell–mediated autoimmune bone marrow aplasia, without a known etiologic trigger. Clonal expansion of CD8+ effector T lymphocytes can occur following vaccination and accompany graft dysfunction or aplastic anemia relapse.

Cited by 17 publications

References 24 publications

Severe aplastic anemia after COVID-19 mRNA vaccination: Causality or coincidence?

Severe aplastic anemia after COVID-19 mRNA vaccination: Causality or coincidence?

A case of severe aplastic anaemia after SARS‐CoV‐2 vaccination

Myeloid dendritic cells in severe aplastic anemia patients exhibit stronger phagocytosis

Contact Info

Product

Resources

About