Case Report: Rotavirus Vaccination and Severe Combined Immunodeficiency in Japan.
Case Report: Rotavirus Vaccination and Severe Combined Immunodeficiency in Japan.
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DOI：
10.3389/fimmu.2022.786375
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发表时间：
2022
影响因子：
7.3
通讯作者：
Kanegane H
中科院分区：
文献类型：
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作者：
Tanita K;Kawamura Y;Miura H;Mitsuiki N;Tomoda T;Inoue K;Iguchi A;Yamada M;Yoshida T;Muramatsu H;Tada N;Matsui T;Kato M;Eguchi K;Ishimura M;Ohga S;Imai K;Morio T;Yoshikawa T;Kanegane H
严重联合免疫缺陷（SCID）是一种先天性免疫缺陷，发生率约为1/50，000，主要是由于淋巴细胞分化受损。如果没有治愈性治疗，如造血细胞移植（HCT）或基因治疗，在生命的第一年严重感染可能会使这种情况致命。当患者有活动性感染时，HCT的结果很差，因此需要在感染发生前进行早期诊断。在日本确诊的5例SCID病例中，在确诊前已接种口服轮状病毒疫苗。在这项研究中，我们证明了从他们的粪便轮状病毒是疫苗衍生株。在某些情况下，严重的胃肠炎引发了SCID的诊断。然而，在首次轮状病毒疫苗接种之前，可使用检测T细胞受体切除环（TRECs）的测定法进行新生儿SCID筛查。因此，为了改善日本SCID患者的预后，我们应该在日本全国范围内建立一个新生儿TRECs筛查系统。
Severe combined immunodeficiency (SCID) is an inborn error of immunity that occurs in approximately 1 in 50,000 births, mainly due to impaired lymphocyte differentiation. Without curative treatment, such as hematopoietic cell transplantation (HCT) or gene therapy, severe infection in the first year of life could make this condition fatal. The results of HCT are poor when patients have active infections, thus requiring early diagnosis before onset of infection. In five cases of SCID diagnosed in Japan, the oral rotavirus vaccine had been administered before diagnosis. In this study, we demonstrated that the rotavirus from their stools was a vaccine-derived strain. In some cases, severe gastroenteritis triggered the diagnosis of SCID. However, newborn screening for SCID is available before the first rotavirus vaccination using assays for the detection of T-cell receptor excision circles (TRECs). Therefore, to improve the prognosis of patients with SCID in Japan, we should establish a screening system of TRECs for newborns throughout Japan.