The spectrum of post-vaccination inflammatory CNS demyelinating syndromes

Karussis, Dimitrios; Petrou, Panayiota

doi:10.1016/j.autrev.2013.10.003

Cited by 181 publications

(212 citation statements)

References 138 publications

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“…Myelitis is an uncommon complication in influenza vaccination, with a literature review of cases published between 1979 to 2013 noting 9 cases of myelitis developing after influenza immunization. 6 A recent case study described a 41 y old man who developed transverse myelitis following influenza immunization. 7 Acute myelitis can also occur occasionally after polio or HPV vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…7 Acute myelitis can also occur occasionally after polio or HPV vaccination. 6,8 Long term myelitis can also develop following acute HSV-2 infection. One case series reported 7 patients who developed myelitis with paraplegia or tetraplegia following acute HSV-2 infection; all were treated with antiviral therapy but only 2 made a substantial recovery.…”

Section: Discussionmentioning

confidence: 99%

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HSV2 reactivation and myelitis following influenza vaccination

Lieberman

Curtis

2016

Human Vaccines & Immunotherapeutics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

HSV2 reactivation and myelitis following influenza vaccination

Lieberman

Curtis

2016

Human Vaccines & Immunotherapeutics

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“…TM may exist as part of a multifocal central nervous system disease (e.g., multiple sclerosis), multisystemic disease (e.g., SLE), or as an isolated idiopathic entity [141]. A recent review (2014) summarizes nine published cases of CNS demyelination, including not only myelitis but also optic neuritis and encephalitis, following HPV vaccination [142]. There are previous reports of CNS inflammatory syndromes following HPV vaccination describing a 10-day to 5-month time lapse from vaccination to symptom onset, with a minimum of a 21-day interval in cases developing myelitis.…”

Section: Hpv Vaccine and Transverse Myelitismentioning

confidence: 99%

Vaccination and autoimmune diseases: is prevention of adverse health effects on the horizon?

et al. 2017

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Autoimmune diseases, including multiple sclerosis and type 1 diabetes mellitus, affect about 5% of the worldwide population. In the last decade, reports have accumulated on various autoimmune disorders, such as idiopathic thrombocytopenia purpura, myopericarditis, primary ovarian failure, and systemic lupus erythematosus (SLE), following vaccination. In this review, we discuss the possible underlying mechanisms of autoimmune reactions following vaccinations and review cases of autoimmune diseases that have been correlated with vaccination. Molecular mimicry and bystander activation are reported as possible mechanisms by which vaccines can cause autoimmune reactions. The individuals who might be susceptible to develop these reactions could be especially not only those with previous post-vaccination phenomena and those with allergies but also in individuals who are prone to develop autoimmune diseases, such as those with a family history of autoimmunity or with known autoantibodies, and the genetic predisposed individuals.Further research is encouraged into the direct associations between vaccines and autoimmune conditions, and the biological mechanisms behind them.

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“…However, problems generated by immunization, such as vaccination‐related Guillain–Barré syndrome, narcolepsy, acute disseminating encephalomyelitis, and multiple sclerosis, are becoming a public concern 23, 47, 54, 55, 56, 57, 58, 59, 60, 61. Whether the cellular and humoral autoimmunity related to LA‐JEV vaccination is involved in other immune‐mediated neurological diseases also remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Molecular and clinical relationship between live‐attenuated Japanese encephalitis vaccination and childhood onset myasthenia gravis

Zhang

Xiao

et al. 2018

Annals of Neurology

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ObjectiveThe incidence of childhood onset myasthenia gravis (CMG) in China is higher than that in other countries; however, the reasons for this are unclear.MethodsWe investigated the clinical and immunological profiles of CMG, and assessed the potential precipitating factors. For the mouse studies, the possible implication of vaccination in the pathogenesis was explored.ResultsIn our retrospective study, 51.22% of the 4,219 cases of myasthenia gravis (MG) were of the childhood onset type. The cohort study uncovered that the pathophysiology of CMG was mediated by immune deviation, rather than through gene mutations or virus infections. The administration of the live‐attenuated Japanese encephalitis vaccine (LA‐JEV), but not the inactivated vaccine or other vaccines, in mice induced serum acetylcholine receptor (AChR) antibody production, reduced the AChR density at the endplates, and decreased both muscle strength and response to repetitive nerve stimulation. We found a peptide (containing 7 amino acids) of LA‐JEV similar to the AChR‐α subunit, and immunization with a synthesized protein containing this peptide reproduced the MG‐like phenotype in mice.InterpretationOur results describe the immunological profile of CMG. Immunization with LA‐JEV induced an autoimmune reaction against the AChR through molecular mimicry. These findings might explain the higher occurrence rate of CMG in China, where children are routinely vaccinated with LA‐JEV, compared with that in countries, where this vaccination is not as common. Efforts should be made to optimize immunization strategies and reduce the risk for developing autoimmune disorders among children. Ann Neurol 2018;84:386–400

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The spectrum of post-vaccination inflammatory CNS demyelinating syndromes

Cited by 181 publications

References 138 publications

HSV2 reactivation and myelitis following influenza vaccination

HSV2 reactivation and myelitis following influenza vaccination

Vaccination and autoimmune diseases: is prevention of adverse health effects on the horizon?

Molecular and clinical relationship between live‐attenuated Japanese encephalitis vaccination and childhood onset myasthenia gravis

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