Schwere Komplikationen bei Lebendimpfungen

ZUSAMMENFASSUNG

Lebendimpfstoffe erzeugen eine starke, lang-anhaltende Immunität und haben Millionen Menschenleben weltweit gerettet. Sehr selten jedoch können sich angeborene Störungen des Immunsystems nach einer Lebendimpfung manifestieren. Im vorliegenden Beitrag sollen anhand monogenetischer Immundefekte entscheidende Mechanismen der antiviralen Immunität diskutiert werden. Das Verständnis der jeweiligen pathophysiologischen Grundlagen erlaubt Rückschlüsse beispielsweise auf die Impfstoffentwicklung.

ABSTRACT

Live-viral vaccinations constitute strong and durable immune responses and have saved millions of lives worldwide. However, in rare circumstances, inborn errors of immunity can manifest following live-viral vaccination. This article discusses important mechanism of human antiviral immunity highlighted by monogenic immune deficiency states. Understanding the pathomechanistic basis of these rare defects might help improving live-viral vaccine efficiency and safety.

Schlüsselwörter

Lebendimpfung - angeborener Immundefekt - antivirale Immunität - Typ-I-Interferon

Keywords

Live-viral vaccine - inborn error of immunity - antiviral immunity - type I interferon

Publication History

Article published online:
12 June 2023

• Literatur

• 1 Bishop R, Davidson G, Holmes I, Ruck B. Virus particles in epithelial cells of duodenal mucosa from children with acute non-bacterial gastroenteritis. Lancet 1973; 302 7841 1281-1283
• 2 Troeger C, Blacker BF, Khalil IA. et al Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis 2018; 18 (11) 1211-1228
• 3 Patel N, Hertel P, Estes M. et al Vaccine-Acquired Rotavirus in Infants With Severe Combined Immunodeficiency. N Engl J Med 2010; 362 (04) 314-319
• 4 Wood DJ, David TJ, Chrystie IL, Totterdell B. Chronic enteric virus infection in two T-cell immunodeficient children. J Med Virol 1988; 24 (04) 435-444
• 5 Perret K, Jachno K, Nolan T, Harrison L. Association of rotavirus vaccination with the incidence of type 1 diabetes in children. JAMA Pediatr 2019; 173 (03) 280-282
• 6 Petrova VN, Sawatsky B, Han AX. et al Incomplete genetic reconstitution of B cell pools contributes to prolonged immunosuppression after measles. Sci Immunol 2019; 04 (41) eaay6125
• 7 Moss WJ, Griffin DE. Measles. Lancet 2012; 379 9811 153-164
• 8 Hambleton S, Goodbourn S, Young DF. et al STAT2 deficiency and susceptibility to viral illness in humans. Proc Natl Acad Sci 2013; 110 (08) 3053-3058
• 9 Hernandez N, Bucciol G, Moens L. et al Inherited IFNAR1 deficiency in otherwise healthy patients with adverse reaction to measles and yellow fever live vaccines. J Exp Med 2019; 216 (09) 2057-2070
• 10 Duncan CJA, Randall RE, Hambleton S. Genetic Lesions of Type I Interferon Signalling in Human Antiviral Immunity. Trends Genet 2021; 37 (01) 46-58
• 11 Bastard P, Rosen LB, Zhang Q. et al Autoantibodies against type I IFNs in patients with life-threatening COVID-19. Science 2020; 370 6515 eabd4585
• 12 Zhang Q, Pizzorno A, Miorin L. et al Autoantibodies against type I IFNs in patients with critical influenza pneumonia. J Exp Med 2022; 219 (11) e20220514
• 13 Hviid A, Rubin S, Mühlemann K. Mumps. Lancet 2008; 371 9616 932-944
• 14 Duncan CJA, Mohamad SMB, Young DF. et al Human IFNAR2 deficiency: Lessons for antiviral immunity. Sci Transl Med 2015; 07 (307) 307ra154
• 15 Shahni R, Cale CM, Anderson G. et al Signal transducer and activator of transcription 2 deficiency is a novel disorder of mitochondrial fission. Brain 2015; 138 (10) 2834-2846
• 16 Morfopoulou S, Mee ET, Connaughton SM. et al Deep sequencing reveals persistence of cell-associated mumps vaccine virus in chronic encephalitis. Acta Neuropathol 2017; 133 (01) 139-147
• 17 Boner A, Wilmott RW, Dinwiddie R. et al Desquamative interstitial pneumonia and antigen-antibody complexes in two infants with congenital rubella. Pediatrics 1983; 72 (06) 835-839
• 18 Bodemer C, Sauvage V, Mahlaoui N. et al Live rubella virus vaccine long-term persistence as an antigenic trigger of cutaneous granulomas in patients with primary immunodeficiency. Clin Microbiol Infect 2014; 20 (10) O656-663
• 19 Perelygina L, Icenogle J, Sullivan KE. Rubella virus-associated chronic inflammation in primary immunodeficiency diseases. Curr Opin Allergy Clin Immunol 2020; 20 (06) 574-581
• 20 Buchbinder D, Hauck F, Albert MH. et al Rubella Virus-Associated Cutaneous Granulomatous Disease: a Unique Complication in Immune-Deficient Patients, Not Limited to DNA Repair Disorders. J Clin Immunol 2019; 39 (01) 81-89
• 21 Willis ED, Woodward M, Brown E. et al Herpes zoster vaccine live: A 10 year review of post-marketing safety experience. Vaccine 2017; 35 (52) 7231-7239
• 22 Macklin G, Diop OM, Humayun A, Shahmahmoodi S. et al Update on Immunodeficiency-Associated Vaccine-Derived Polioviruses – Worldwide , July 2018 – December 2019. MMWR Morb Mortal Wkly Rep 2020; 69 (28) 913-917
• 23 McDonald SL, Weldon WC, Wei L. et al Neutralization capacity of highly divergent type 2 vaccine-derived polioviruses from immunodeficient patients. Vaccine 2020; 38 (14) 3042-3049
• 24 Shaghaghi M, Soleyman-jahi S, Abolhassani H. et al New insights into physiopathology of immunodeficiency-associated vaccine-derived poliovirus infection; systematic review of over 5 decades of data. Vaccine [Internet] 2018; 36 (13) 1711-1719
• 25 Winkelstein JA, Marino MC, Lederman HM. et al X-linked agammaglobulinemia: Report on a United States registry of 201 patients. Medicine (Baltimore) 2006; 85 (04) 193-202