疫苗相关的心脏不良事件,包括SARS-Cov-2心肌炎、组胺升高的病因学假说

D. Ricke
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引用次数: 2

摘要

背景:罕见的心脏不良事件报道接种疫苗后。据报道,对于SARS-CoV-2 mRNA Spike疫苗,这些心脏不良事件的数量更高,心肌炎在年轻男性中不成比例地发生。与包括SARS-CoV-2在内的疫苗相关的这些心脏不良事件的病因尚不清楚。与SARS-CoV-2 mRNA刺突疫苗暂时相关的这些心脏不良事件频率较高的病因尚不清楚。目的:数据挖掘疫苗相关心脏不良事件,以了解COVID-19 mRNA相关心肌炎和心包炎不良事件。方法:从疫苗不良事件报告系统(VAERS)中总结1990年至2022年4月1日期间所有疫苗的所有不良事件,重点是心脏不良事件。结果:在多种不相关的疫苗中观察到类似的心脏不良事件模式,其发生率与疫苗反应原性水平成正比,定义了所有不良事件。本文提出了一种假设,即对疫苗的先天免疫反应导致疫苗接种后组胺水平升高;达到的组胺水平可能超过接种者的组胺耐受水平数天,组胺水平可能与疫苗的反应性水平相关。此外,有人提出,升高的组胺水平是导致报告的心脏不良事件。对于心肌炎和心包炎报道的不良事件,组胺水平升高可引起心脏毛细血管周细胞血管收缩,随后出现局部缺血和缺氧;随后是肌钙蛋白从受缺氧影响的肌细胞中释放出来。这一假设得到了在VAERS中接种SARS-CoV-2 mRNA Spike疫苗后报告的不良事件的时间发生时间的支持。结论:接种多种不相关疫苗后立即发生的心脏不良事件可能暗示免疫反应引起的组胺水平升高是导致这些不良事件的原因。与患者相关。提出了一种与疫苗接种有关的心脏不良事件的病因模型。如果得到验证,该模型确定了可能的候选治疗方法,以评估降低疫苗接种者这些心脏不良事件的严重程度和频率的潜力。
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Vaccines Associated Cardiac Adverse Events, Including SARS-Cov-2 Myocarditis, Elevated Histamine Etiology Hypothesis
Background: Rare cardiac adverse events are reported post vaccinations. For the SARS-CoV-2 mRNA Spike vaccines, higher numbers of these cardiac adverse events are being reported with myocarditis disproportionately occurring in younger males. The etiology of these cardiac adverse events associated with vaccines including SARS-CoV-2 is unknown. The etiology of the higher frequency of these cardiac adverse events temporally associated with SARS-CoV-2 mRNA Spike vaccines is also unknown. Aim: Data mine vaccine associated cardiac adverse events to gain insights into COVID-19 mRNA associated myocarditis and pericarditis adverse events. Methods: All adverse events, with a focus on cardiac adverse events, were summarized from the Vaccine Adverse Event Reporting System (VAERS) for all vaccines from 1990 to April 1, 2022. Results: Analogous patterns of cardiac adverse events were observed for multiple unrelated vaccines with occurrences proportional to vaccine reactogenicity level defined all adverse events. This article proposes the hypothesis that innate immune responses to vaccines cause elevated histamine levels post vaccination; the histamine level reached may exceed the vaccinees’ histamine tolerance level for several days, with the histamine level likely correlating with the vaccine reactogenicity level. Further, it is proposed that the elevated histamine level is causative for the reported cardiac adverse events. For myocarditis and pericarditis reported adverse events, the elevated histamine levels may induce cardiac capillary pericyte vasoconstrictions followed by localized ischemia and anoxia; this is followed by the release of troponin from myocyte cells affected by anoxia. This hypothesis is supported by the temporal onset timing of adverse events reported following SARS-CoV-2 mRNA Spike vaccinations in VAERS. Conclusion: Onset of cardiac adverse events immediately following vaccinations for multiple unrelated vaccines may implicate elevated histamine levels from immune responses as causative for these adverse events. Relevance for patients. An etiology model for cardiac adverse events temporally associated with vaccination is proposed. If validated, this model identifies possible candidate treatments for evaluation with the potential to reduce the severity and frequencies of these cardiac adverse events for vaccinees.
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