metricas
covid
Buscar en
Clinics
Toda la web
Inicio Clinics Does SARS-CoV-2vaccination induce acquired autoimmune discords and inflammatory ...
Información de la revista
Vol. 78.
(enero - diciembre 2023)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Visitas
1064
Vol. 78.
(enero - diciembre 2023)
Comments
Acceso a texto completo
Does SARS-CoV-2vaccination induce acquired autoimmune discords and inflammatory manifestations?
Visitas
1064
Khadija Bahrinia,
Autor para correspondencia
bahrini_khadija@live.fr

Corresponding author.
, Emna Hannachib
a Research Unit UR17DN05, Military Hospital of Tunis, Tunis El-Manar University, Tunis, Tunisia
b Laboratoire de Parasitologie Médicale, Biotechnologies et Biomolécules; LR11-IPT06; Institut Pasteur de Tunis, Université Tunis El-Manar, Tunis-Belvédère, Tunisia
Este artículo ha recibido
Información del artículo
Texto completo
Bibliografía
Descargar PDF
Estadísticas
Texto completo

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has produced an unparalleled setback for the world's economy and health. The most efficient way to reduce infection-related morbidity and mortality is through vaccinations, which are among the most important medical advancements. In response to this pandemic situation, SARS-CoV-2 vaccines are being rapidly developed and most of them have been approved without extensive studies on their side effects and efficacy, compared to traditional vaccines.1,2 In order to prevent infection exacerbation, vaccines are administered to healthy patients, hence side effects and adverse events become quite relevant. As it has been described with other vaccines, many investigations have shown that SARS-CoV-2 vaccination may increase the risk of developing an autoimmune disease such as lupus erythematosus, rheumatoid arthritis, thrombocytopenia2 and uveitis inflammatory disorder.3 To the best of our knowledge, researches investigating the onset of Acquired Hemophilia A (AHA) and sarcoidosis following SARS-CoV-2 vaccination were scarce.

Acquired hemophilia A is a rare autoimmune disease caused by the appearance of neutralizing anti-factor VIII (FVIII) autoantibodies in individuals with no previous history of bleeding.4 Most often, patients can simultaneously be affected by multiple diseases, including, malignancies, and several autoimmune disorders such as systemic lupus erythematosus, autoimmune thyroiditis, rheumatoid arthritis, or pemphigus.5 Among 50% of cases, the underlying triggering cause remains unknown. For this reason, an extensive history of immunological conditions, drugs, and the wide range of linked medical issues that predispose the patient to acquired hemophilia should be gathered.6

The pathophysiology of AHA is not well elucidated. However, T-cells are thought to have a role, as are several genetic polymorphisms.7 The development of autoantibodies and vaccination has long been associated. Due to antigenic mimicry and the stimulation of dormant autoreactive T and B-cells, it has been suggested that vaccination may trigger an autoimmune reaction.8 In this context, Schultz NH and collaborators have demonstrated that antibodies against COVID-19 spike glycoproteins can react with host peptide protein sequences that are structurally similar to the membranes of coagulation factors or red blood cells.9 This can lead to an autoimmune mechanism in the cases of acquired hemophilia A.10 In these circumstances, numerous cases have reported that SARS-CoV-2 vaccination can be potential triggers for AHA in healthy patients.11–14

Sarcoidosis is another inflammatory disorder that can be observed following SARS-CoV-2 vaccination. It is a multisystem disorder of unknown etiology. Some cases are linked to autoimmune involvement, self-antigens, and genetic factors that cause inflammation. It has been reported that SARS-CoV-2 vaccination can induce inflammatory phenomena like sarcoidosis.2 Few new cases of sarcoidosis have been reported after COVID-19 infection, and even after SARS-CoV-2 vaccination.15 COVID-19 vaccine-associated sarcoidosis can be explained not only by abnormal regulation of the immune system16 but also by an impairment of the angiotensin pathway.17 In this context, it has been reported that spike protein binds to the angiotensin II receptor which allows the virus to enter the cell.18 Evenly, immune dysregulation and inflammatory activation can be caused by COVID-19 vaccine adjuvants.19 Reviewing the literature, the authors found two healthy cases which have developed systemic sarcoidosis following SARS-CoV-2 vaccination. These two subjects have received the booster doses of the ribonucleic acid vaccine and symptoms started after the first dose. The main symptoms of these cases were fever, fatigue, dyspnea, and dry cough.20,21 Previously, it has been reported a case of sarcoidosis exacerbation presenting after SARS-CoV-2 vaccination.22

In conclusion, several case reports have suggested vaccines may trigger an autoimmune reaction. However, it should nonetheless be highlighted the overwhelming benefits of SARS-CoV-2 vaccination and underling that advantages can exceed potential adverse reactions in order to prevent COVID-19 morbidity and mortality. Therefore, mechanisms showing the association between vaccines, autoimmunity phenomena, and inflammatory manifestations remain poorly understood and need to be further investigated. For this reason, clinicians need to be attuned to the uncommon chance of the possible flare-ups of underlying diseases such as AHA and sarcoidosis.

Data availability statement

All data generated and analyzed in this present study are available from the corresponding author upon reasonable request.

Funding

No specific grant was given to this research.

Acknowledgments

None.

References
[1]
S. Kashte, A. Gulbake, S.F. El-Amin III, A. Gupta.
COVID-19 vaccines: rapid development, implications, challenges and future prospects.
Hum Cell, 34 (2021), pp. 711-733
[2]
Y. Chen, Z. Xu, P. Wang, X.M. Li, Z.W. Shuai, D.Q. Ye, HF. Pan.
New-onset autoimmune phenomena post-COVID-19 vaccination.
Immunology, 165 (2022), pp. 386-401
[3]
R.J. Kaur, S. Dutta, P. Bhardwaj, J. Charan, S. Dhingra, P. Mitra, et al.
Adverse events reported from COVID-19 vaccine trials: a systematic review.
Indian J Clin Biochem, 36 (2021), pp. 427-439
[4]
A. Tiede, P. Collins, P. Knoebl, J. Teitel, C. Kessler, M. Shima, et al.
International recommendations on the diagnosis and treatment of acquired hemophilia A.
Haematologica, 105 (2020), pp. 1791-1801
[5]
A. Duminuco, M. Calagna, U. Markovic, B. Esposito, S. Grasso, C. Riccobene, et al.
Acquired hemophilia A following COVID-19 vaccination – The importance of prompt diagnosis: a case report.
Transfus Apher Sci, 62 (2023),
[6]
A. Huth-Kühn, F. Baudo, P. Collins, J. Ingerslev, C.M. Kessler, H. Lévesque, et al.
International recommendations on the diagnosis and treatment of patients with acquired hemophilia A.
Haematologica, 94 (2009), pp. 566-575
[7]
A. Mahendra, S. Padiolleau-Lefevre, S.V. Kaveri, S. Lacroix-Desmazes.
Do proteolytic antibodies complete the panoply of the autoimmune response in acquired haemophilia A?.
Br J Haematol, 156 (2012), pp. 3-12
[8]
D.C. Wraith, M. Goldman, P-H. Lambert.
Vaccination and autoimmune disease: what is the evidence?.
Lancet, 362 (2003), pp. 1659-1666
[9]
N.H. Schultz, I.H. Sørvoll, A.E. Michelsen, L.A. Munthe, F. Lund-Johansen, M.T. Ahlen, et al.
Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination.
N Engl J Med, 384 (2021), pp. 2124-2130
[10]
D.S. Soliman, A. Al Battah, D. Al Faridi, F. Ibrahim.
Acquired hemophilia A developed post COVID-19 vaccine: an extremely rare complication.
J Med Cases, 13 (2022), pp. 1-4
[11]
K. Parmar, S. Singh, L. Tijani, DA. Garcia.
Acquired Hemophilia Following COVID-19 and Influenza Vaccination: a Systematic Review.
Blood, 140 (2022), pp. 5608-5609
[12]
M. Happaerts, T. Vanassche.
Acquired hemophilia following COVID-19 vaccination: case report and review of literature.
Res Pract Thromb Haemost, 6 (2022), pp. e12785
[13]
H. Al Hennawi, M.K. Al Masri, M. Bakir, M. Barazi, F. Jazaeri, T.N. Almasri, et al.
Acquired hemophilia A post-COVID-19 vaccination: a case report and review.
Cureus, 14 (2022), pp. e21909
[14]
H. Hosoi, M. Tane, H. Kosako, M. Ibe, M. Takeyama, S. Murata, et al.
Acute-type acquired hemophilia A after COVID-19 mRNA vaccine administration: a new disease entity?.
J Autoimmun, 133 (2022),
[15]
J.-G. Rademacher, B. Tampe, P. Korsten.
First report of two cases of löfgren's syndrome after SARS-CoV-2 vaccination-coincidence or causality?.
Vaccines, 9 (2021), pp. 1313
[16]
T. Matsuo, H. Honda, T. Tanaka, K. Uraguchi, M. Kawahara, H. Hagiya.
COVID-19 mRNA Vaccine – associated Uveitis Leading to Diagnosis of Sarcoidosis: Case Report and Review of Literature.
J Investig Med High Impact Case Rep, 10 (2022),
[17]
M. Eskandari, P. Zhang.
Increased Angiotensin 2 Expression in Sarcoid Granulomas.
Am J Clin Pathol, 144 (2015),
[18]
D. Canu, M.-S. Doutre.
Regression of sarcoidosis skin lesions after receiving the Moderna anti-coronavirus disease 2019 vaccine.
J Dermatol, 49 (2022), pp. e378-e380
[19]
S. Ndeupen, Z. Qin, S. Jacobsen, A. Bouteau, H. Estanbouli, B.Z. Igyártó.
The mRNA-LNP platform's lipid nanoparticle component used in preclinical vaccine studies is highly inflammatory.
Iscience, 24 (2021),
[20]
J. Santiago, G. Negron-Ocasio, S. Ortiz-Troche, K.P. Rodriguez, J. Ramirez-Marquez, L. Velazquez, et al.
Rare expression of systemic sarcoidosis after a novel RNA vaccine.
Chest, 160 (2021), pp. A1233-A1234
[21]
A.A. Mitma, P. Saluja, E.F. Quiroga, C. Chen, M. Joshi.
Multisystem sarcoidosis associated with the covid-19 mrna vaccine.
Chest, 162 (2022), pp. A1288
[22]
R. Kapil, J. Higuero Sevilla, S. Woo, M. Gulati.
Possible sarcoidosis flare after SARS CoV-2 Vaccination?, C39. Case reports: sarcoidosis is always in the differential.
Am Thoracic Soc., (2022),
Copyright © 2023. HCFMUSP
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Quizás le interese:
10.1016/j.clinsp.2023.100175
No mostrar más