Immunization with vaccines and Sjögren's syndrome

Abstract

Sjögren's syndrome (SjS) is a systemic autoimmune disease with complex pathogenesis and still unknown etiology. Infections are listed among the main environmental factors triggering the disease in genetically predisposed individuals. Among other environmental factors, the role of immunization with vaccines in the etiopathogenesis of SjS has not yet been elucidated. Although immunization with vaccines is safe for the majority of subjects, in rare cases it can trigger or exacerbate autoimmune and rheumatic inflammatory conditions. In this paper we investigate the possible links between immunization with vaccines and the pathogenesis of SjS. The current scientific evidence about safety and efficacy of vaccines in the course of SjS are also reviewed.

Keywords::

• adjuvant
• aluminium
• ASIA
• autoantibodies
• autoimmune/inflammatory syndrome induced by adjuvants
• immunization
• Sjögren's syndrome
• vaccines

Financial & competing interests disclosure

Y Shoenfeld appeared in court for subjects afflicted by vaccines as a medical consultant. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Sjögren's syndrome (SjS) is a multifaceted and multifactorial autoimmune rheumatic disease with still unclear etiology. Recent evidences support the contribution of both innate and adaptive immune response in its pathogenesis.

• Vaccines are able to evoke innate and adaptive immunity through several mechanisms because of their heterogeneous composition (infectious components, adjuvants, preservatives), and similar to infectious agents, in rare cases they can induce the appearance of autoantibodies or overt a full-blown autoimmune rheumatic disease in genetically predisposed subjects.

• Four medical conditions – Gulf-War syndrome, siliconosis, macrophage myofasciitis syndrome and post-vaccination phenomena – have been recently gathered in a common definition of ASIA – autoimmune/inflammatory syndrome induced by adjuvants.

• As pathogenesis of SjS remains unclear, the role of vaccines as triggers of the autoimmunity process in this disease cannot be excluded and needs further investigations.

• Immunogenity and safety of vaccines commonly administered in immunosuppressed patients affected with SjS require further and wider population studies.

Notes

Adapted with permission from [17].