Epidemiology of autoimmune reactions induced by vaccination
Epidemiology of autoimmune reactions induced by vaccination
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DOI：
10.1006/jaut.2000.0491
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发表时间：
2001-05-01
影响因子：
12.8
通讯作者：
DeStefano, F
中科院分区：
文献类型：
--
作者：
Chen, RT;Pless, R;DeStefano, F
为了让疫苗“起作用”，必须刺激免疫系统。免疫接种可能导致自身免疫性疾病（AID）的发展受到质疑。由于艾滋病是在没有免疫接种的情况下发生的，免疫接种不太可能是艾滋病的主要原因。然而，需要进行流行病学研究，以评估免疫接种是否会增加某些易感个体的风险。本文讨论了支持和反对接种疫苗作为艾滋病的危险因素的证据。免疫接种导致艾滋病的证据来自几个来源，包括动物研究，单个和多个病例报告，以及生态关联。然而，更严格的调查未能证实大多数指控。不幸的是，这个问题仍然很难解决，因为对于大多数艾滋病，对病因、背景发病率和其他发展风险因素的认识有限。在缺乏来自对照研究的实验证据的情况下，这些信息对于使用有限的可用数据进行任何适当的因果关系评估是必要的。一些说明性的例子进行了讨论，以突出什么是已知的，什么仍然有待探讨，以及流行病学的证据，将需要更好地解决这些问题的类型。例如，免疫与多发性硬化症（和其他脱髓鞘疾病）、1型糖尿病、格林-巴利综合征、特发性血小板减少性紫癜和类风湿性关节炎可能存在关联。(C)北京：科学出版社.
In order for vaccinations to 'work', the immune system must be stimulated. The concern that immunizations may lead to the development of autoimmune disease (AID) has been questioned. Since AID occur in the absence of immunizations, it is unlikely that immunizations are a major cause of AID. Epidemiological studies are needed, however, to assess whether immunizations: may increase the risk in some susceptible individuals. This paper discusses the evidence for and against vaccination as a risk factor for AID. Evidence for immunizations leading to AID come from several sources including animal studies, single and multiple case reports, and ecologic association. However more rigorous investigation has failed to confirm most of the allegations. Unfortunately the question remains difficult to address because for most AIDs, there is Limited knowledge of the etiology, background incidence and other risk factors for their development. This information is necessary, in the absence of experimental evidence derived from controlled studies, for any sort of adequate causality assessment using the limited data that are available. Several illustrative examples are discussed to highlight what is known and what remains to be explored, and the type of epidemiological evidence that would be required to better address the issues. Examples include the possible association of immunization and multiple sclerosis (and other demyelinating diseases), type 1 diabetes mellitus, Guillain-Barre Syndrome, idiopathic thrombocytopenic purpura, and rheumatoid arthritis. (C) 2001 Academic Press.