LIPSIA 7 APRILE 2016 Girolamo Giannotta.
PS14 Parallel Session
PARALLEL SESSION 14: VACCINES AND AUTOIMMUNITY
07-Apr-2016 16:30 18:30
POST-VACCINATION INFLAMMATORY SYNDROME: A NEW SYNDROME?
Background: HPV post-vaccination reactions are characterized by debilitating neurological symptoms such as chronic fatigue, chronic pain, cognitive and motor deficits, myalgia, impaired attention and memory, dizziness, headache and sleep disturbances.
Hypothesis: Starting from the mechanisms of inflammatory pain, I think that a number of clinical post-vaccination syndromes may have a common pathogenetic basis. The periferic pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), expressed after the injection of the vaccine (Fig. 1), can reach the brain and, independently neuroinflammation, can cause a post-vaccination inflammatory syndrome (Fig. 2). If a neuroinflammation is present, it could be followed by autoimmune reactions and neurodegeneration.
Table 1 lists all the clinical syndromes in which the pro-inflammatory cytokines are increased. IL-1β represents a major upstream cytokine that controls the local pro-inflammatory cascade and thereby affects the balance between protective immunity and destructive inflammation. Increased levels of IL-1β, IL-6, and TNF-α in the brain cause cognitive impairment, sleep disorders, and reduced motor activity. High levels of these cytokines are found in fibromyalgia, chronic fatigue, small fiber neuropathy, pathological pain, ADEM, myofascial dysfunction, and CFS. IL-1β causes pathological pain and fatigue and is elevated in peripheral neuropathic pain and CRPS type I.
Conclusion: These post-vaccination reactions fall into the ASIA syndrome, but represent a sub-group of clinical syndromes determined by the excessive expression and secretion of pro-inflammatory cytokines. IL-1β is always present in syndromes described here. Eventually, all of these clinical entities could be included in a post-vaccination inflammatory syndrome.