轮状病毒疫苗真的能降低患乳糜泻和其他自身免疫性疾病的风险吗?

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Rambam Maimonides Medical Journal Pub Date : 2021-10-25 DOI:10.5041/RMMJ.10450
Ibrahim Kiliccalan
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引用次数: 1

摘要

本综述探讨了与正常人群相比,接种轮状病毒(RV)疫苗的个体发生乳糜泻(CD)和其他自身免疫性疾病的风险。乳糜泻是一种吸收不良的慢性免疫介导的肠病,累及小肠。乳糜泻的发病机制是多因素的,粘膜免疫在其发病过程中起重要作用。低黏膜IgA水平显著增加患病风险。轮状病毒是一种引起腹泻的传染因子,特别是在0-24个月的儿童中,并且经常涉及这些儿童与腹泻相关的死亡。已经研制出一种抗RV的口服疫苗。在对RV感染有效的同时,它也有助于提高黏膜免疫力。研究表明,接种RV疫苗的个体患乳糜泻的风险低于未接种疫苗的个体。此外,接种疫苗组发生乳糜泻自身免疫的平均年龄可能高于接受安慰剂的对照组。对接种了不同RV疫苗的儿童和未接种疫苗的儿童进行的进一步研究将提供更有意义的结果。尽管目前的数据表明,RV疫苗接种可能与降低乳糜泻和其他自身免疫性疾病的风险有关,但这仍然是一个悬而未决的问题,需要进行更多的国际调查。
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Is the Rotavirus Vaccine Really Associated with a Decreased Risk of Developing Celiac and Other Autoimmune Diseases?

This review examines the risk of developing celiac disease (CD) and other autoimmune diseases in individuals receiving the rotavirus (RV) vaccine compared to the normal population. Celiac disease is a malabsorptive, chronic, immune-mediated enteropathy involving the small intestine. The pathogenesis of CD is multifactorial, and mucosal immunity plays an important role in its development. Low mucosal IgA levels significantly increase the risk of developing the disease. Rotavirus is an infectious agent that causes diarrhea, particularly in children aged 0-24 months, and is frequently involved in diarrhea-related deaths in these children. An oral vaccine against RV has been developed. While it is effective on RV infection, it also contributes to increasing mucosal immunity. Studies have indicated that individuals immunized with the RV vaccine are at lower risk of developing CD than unvaccinated individuals. In addition, the mean age for developing CD autoimmunity may be higher in the vaccinated group than in controls receiving placebo. Additional studies that include children immunized with different RV vaccines and unvaccinated children would provide more meaningful results. Although current data suggest a possible association of RV vaccination with a reduced risk of developing CD and other autoimmune diseases, this remains an unanswered question that merits greater international investigation.

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来源期刊
Rambam Maimonides Medical Journal
Rambam Maimonides Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
6.70%
发文量
55
审稿时长
8 weeks
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