Can Vaccination Trigger Autoimmune Disorders? A Meta-Analysis.
Can Vaccination Trigger Autoimmune Disorders? A Meta-Analysis.
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DOI：
10.3390/vaccines9080821
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发表时间：
2021-07-25
期刊：
影响因子：
7.8
通讯作者：
Čelko AM
中科院分区：
文献类型：
--
作者：
Petráš M;Lesná IK;Dáňová J;Čelko AM
在过去的几十年里，疫苗接种作为对抗感染的一个重要工具，被认为是自身免疫的可能触发因素。为了证实或驳斥这一假设，进行了一项自身免疫性疾病与免疫相关的荟萃分析(MADVEI)。荟萃分析包括1968-2019年发表的共144项研究，这些研究可在六个数据库中找到，并在2019年11月30日进行了广泛的文献搜索。使用纽卡斯尔-渥太华质量评估量表对研究的偏倚风险进行分类。使用建议评估、发展和评估分级来评估证据的强度。虽然我们的初步分析是根据偏倚风险较低的研究中使用的关联度量进行的，但Madawi结果的稳健性是使用独立于每个研究偏倚风险的度量进行测试的。此外，还进行了亚组分析以确定结果的稳定性。基于总共364个已发表估计的0.99(95%可信区间，0.97-1.02)的综合关联，证实了接种疫苗和未接种疫苗的人发生自身免疫性疾病的情况相同。独立于偏见风险的研究报告的相同水平的关联性得到了足够数量的研究的支持，并且没有严重的限制、不一致、间接、不精确和发表偏见。敏感度分析没有显示初步结果有任何差异。从中长期来看，目前的普通疫苗接种不是任何已检查的自身免疫性疾病的原因。
Vaccination as an important tool in the fight against infections has been suggested as a possible trigger of autoimmunity over the last decades. To confirm or refute this assumption, a Meta-analysis of Autoimmune Disorders Association With Immunization (MADAWI) was conducted. Included in the meta-analysis were a total of 144 studies published in 1968–2019 that were available in six databases and identified by an extensive literature search conducted on 30 November 2019. The risk of bias classification of the studies was performed using the Newcastle–Ottawa Quality Assessment Scale. The strength of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. While our primary analysis was conducted in terms of measures of association employed in studies with a low risk of bias, the robustness of the MADAWI outcome was tested using measures independent of each study risk of bias. Additionally, subgroup analyses were performed to determine the stability of the outcome. The pooled association of 0.99 (95% confidence interval, 0.97–1.02), based on a total of 364 published estimates, confirmed an equivalent occurrence of autoimmune disorders in vaccinated and unvaccinated persons. The same level of association reported by studies independently of the risk of bias was supported by a sufficient number of studies, and no serious limitation, inconsistency, indirectness, imprecision, and publication bias. A sensitivity analysis did not reveal any discrepancy in the primary result. Current common vaccination is not the cause of any of the examined autoimmune disorders in the medium and long terms.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
9.9
作者：
ALTER, M;SPEER, J
通讯作者：
SPEER, J
影响因子：
8.2
作者：
Onkamo, P;Väänänen, S;Tuomilehto, J
通讯作者：
Tuomilehto, J
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG
DOI：
10.1084/jem.170.1.59
发表时间：
1989-07-01
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Duke RC
通讯作者：
Duke RC