par Lambert, Paul-Henri;Goldman, Michel 
Référence The Vaccine Book: Second Edition, Elsevier Inc., page (167-180)
Publication Publié, 2016-07
Référence The Vaccine Book: Second Edition, Elsevier Inc., page (167-180)
Publication Publié, 2016-07
Partie d'ouvrage collectif
| Résumé : | The primary role of the human immune system is to provide protection against pathogenic microbes and other environmental threats. This essential function is tightly regulated so that intact cells and tissues are not subject to immune attacks in normal individuals. However, under some circumstances that include genetic predisposition, immunological dysregulation, and excessive environmental stimulations (eg, infection), recognition of self-antigens may lead to autoimmune pathology. Although the benefit of vaccination against infectious diseases largely outweighs the potential risk of autoimmune adverse effects, this risk deserves a particular attention. The recent introduction of vaccines for adolescents and young adults has increased the risk of purely coincidental association of vaccination and incipient autoimmune diseases, for example, multiple sclerosis, and this led in some countries to overwhelming and detrimental concerns about vaccination.In the chapter we review the reality of this concern for infection-associated autoimmune manifestations and define guidelines for causality assessment after vaccination. We also explore possible approaches to reduce to a minimum the potential autoimmune consequences of new vaccines. Finally, we consider some guidance for the clinician facing the challenge of vaccinating patients with autoimmune diseases. |
