Offit氏の記事のコメントが１４６件になっています。コメントは会員制のためか、医師や医学分野の研究者です。
以下は、ファーマコビジランス（医薬品安全性監視）の仕事をしている方から。
興味深いポイントです。
欧米で避妊用のピルが使用される年代は１０代の後半からですが、この年代とHPVワクチン接種年代が重なるのに
ピルの副作用として自律神経障害が報告されていないことは、HPVワクチンと自律神経障害に関連があることを
示唆しているのではないかということです。
Dr. Rebecca Chandler 10 hours ago
16Like
アメリカで使われているワクチンの成分表です。
製造過程での不純物などもリストされています。
yeast で検索すると、製造工程で yeast が使用されたワクチンがわかります。
https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf
casamino acid は、牛乳由来のアミノ酸、ペプチドを含むもので、これが入っているワクチンは、牛乳アレルギーの子は避ける方が賢明だということです。
cervarix にこの casamino acid が入っていたと読んだ記憶があるのですが、どなたか覚えていらっしゃいませんか？
この成分の製造に、狂牛病の心配がある英国産の牛乳ではなく、ニュージーランド産の牛乳を使用したと明記しているドキュメントがあったように記憶していますが、みつかりませんでした。
前回と前々回のエントリーの論文の著者であるHendrickson先生のコメントが、あの悪名高きNatureのLarsonによるコラムにありました。このコメント欄に、日本のRyo Konnoという人が、変なコメントしているあのコラムです。
要約やタイトルには書いてありませんが、前回のエントリーの論文は、ガーダシル後の発症だと思われます。
Jeanne Hendrickson •2015-12-05 12:52 PM
Reflex sympathetic dystrophy, also known as complex regional pain syndrome (CRPS), has recently been shown to be associated with autoantibodies against β2-adrenergic and muscarinic M2 receptors. In addition to pain and sudomotor/vasomotor symptoms, dysautonomia is also observed in a subset of CRPS patients. Despite its severity, there are few effective therapies for CRPS described to date. We report a case of a 14-year-old girl with CRPS of her right leg and dysautonomia (gastroparesis, postural tachycardia) refractory to multiple therapies, successfully treated with therapeutic plasma exchange (TPE) with albumin replacement. The patient, who has serum anti β2-adrenergic and muscarinic M2 receptor autoantibodies in addition to nicotinic acetylcholine receptor ganglionic autoantibodies, underwent an initial course of five TPEs over a 2-week period. She demonstrated a clinical response to TPE as manifested by a rapid improvement in her fatigue and gastroparesis, with a gradual yet significant improvement in her leg pain and sudomotor/vasomotor flares. Following the loading procedures, the patient was treated with rituximab. She continues to require periodic TPE to maintain a remission, with additional immunosuppression being considered long term. Although further studies are needed, TPE (in combination with immunosuppression) may be an appropriate therapy for CRPS patients with detectable autoantibodies, as it is for better characterized diseases with autoantibodies against neuronal surface receptors such as myasthenia gravis or Lambert Eaton myasthenic syndrome. J. Clin. Apheresis 31:368-374, 2016. © 2015 Wiley Periodicals, Inc.
© 2015 Wiley Periodicals, Inc.
HPVワクチンと自律神経障害： 自己抗体評価とHLAタイピングを考慮すること
Volume 34, Issue 38, 31 August 2016, Pages 4468
Letter to the Editor
We read with interest the paper by Brinth et al. [1] . Recently, we reported a case of a 14-year-old girl with similar symptoms to those described in other patients (dysautonomia including POTS and GI dysmotility, in addition to neuropathy/CRPS) [...
Autoimmunity; Complex regional pain syndrome; Dysautonomia; HPV; Human papilloma virus vaccination
これは、イェール大学のヘンドリックソン先生が書いた、デンマークのブリンス先生の論文に対するレターです。ヘンドリックソン先生も同様の症状をもつ１４歳の女児の症例（ポッツ、消化管運動障害、神経症状とCRPSなど）を報告したということで、自己抗体とHLA型を調べてみたらどうかと提案しているのだと思います。
これで、HPVワクチン後の自己免疫性の自律神経障害が、オーストラリア、アメリカ、デンマーク、イタリア、日本から、大学病院の先生が症例報告していることになりました。オーストラリアとアメリカの論文には、HPVワクチンの接種の有無が明記されていないことから、これらの国では副反応の報告が不当に隠蔽されているのではないかと疑われます。
Paul Offit 氏のロタウイルスワクチンを摂取した翌日に死亡した乳児、フィンランドにて。
VAERS ID:
| 630816 (history) | Vaccinated: | 2016-03-02 | |
| Age: | 0.2 | Onset: | 2016-03-03, Days after vaccination: 1 |
| Gender: | Unknown | Submitted: | 2016-03-07, Days after onset: 4 |
| Location: | Foreign | Entered: | 2016-03-07 |
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Paul Offit 氏の記事のコメント欄にすごいことが書いてありました。リンク
百日咳ワクチンは、粘膜免疫に有効でないだけでなく、気道にコロニーを作って無症状のキャリアーとし、周りにいる人に菌を広げるそうです。
さらに悪いことに、この気道コロニーは、多発性硬化症を引き起こす可能性があるそうです。
ちなみに、Paul Offit 氏は、メルク社のロタウイルスワクチンの開発者です。少数ですが腸重積がおこるワクチンです。
Vinu Arumugham1 day ago
Dr. Stephen Cox,
As you may know, the acellular pertussis vaccine does NOT prevent transmission. It fails to provide mucosal immunity. So vaccine recipients become asymptomatic carriers due to airway colonization. They silently spread the disease to infants who are too young to be vaccinated. The exact opposite of herd immunity. It took the FDA more than a decade to discover it.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm
To make matters worse, pertussis colonization causes multiple sclerosis.
The potential role of subclinical Bordetella Pertussis colonization in the etiology of multiple sclerosis
http://www.sciencedirect.com/science/article/pii/S0171298515301078
California STILL mandates TdaP (acellular pertussis) to "protect infants" (AB 354).
How do you justify this pseudoscience? Where was the "surveillance" system?
Vaccines are important. But with today's vaccines, vaccine safety is an oxymoron.
５月にブッシュが来日した際に日本政府がGAVIへ、7.6千万USドルの寄付を約束しました。
子宮頸がんワクチンを再開しなくても、結局は、ワクチンにお金が使われることになりました。
しかも、ファイザーのワクチンが含まれるかもしれない。
ファイザーはワイスを買収したらしい。誰かがワイスのワクチン部門にいたらしい。
ファイザーからみれば、日本で子宮頸がんワクチンを再開するよりも、GAVIに寄付してくれたほうがいいということか。
Geneva, 26 May 2016 – The Government of Japan has agreed to contribute a further US$ 76 million to support childhood immunisation in developing countries. Gavi, the Vaccine Alliance will use this first multi-year pledge from Japan to contribute towards efforts to immunise a further 300 million children by 2020, helping to save up to six million lives. 、
Postural tachycardia syndrome (POTS) with anti-NMDA receptor antibodies after human papillomavirus vaccination
http://link.springer.com/article/10.1007/s12026-016-8855-1
Blitshteyn, S. & Brook, J. Immunol Res (2016). doi:10.1007/s12026-016-8855-1
We describe a young woman who developed POTS with positive serum anti-NMDA receptor antibodies and no evidence of encephalitis after vaccination with HPV vaccine, Cervarix. Her symptoms improved significantly with immunomodulatory therapy and re-occurred after immunomodulatory therapy was stopped, suggesting an autoimmune etiology of POTS after vaccination.
サーバリックス後に、抗NMDA受容体抗体が陽性であり脳炎の証拠はないが、ポッツを発症した若年女性の症例。
症状は、免疫調節治療により、顕著に改善したが、免疫調節治療を中止後再発しており、ワクチン後のポッツの病因が自己免疫性であることを示唆している。
Anti-NMDAR encephalitis after resection of melanocytic nevi: report of two cases
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570733/
BMC Neurol. 2015; 15: 165.
We describe 2 female patients in their 20s confirmed with anti-NMDAR encephalitis. They shared two points in common: About several weeks (2 weeks and 5 weeks respectively) before the initial symptom, both of them underwent a resection of melanocytic nevi; the screening tests for an ovarian teratoma and other tumors were all negative.
２０代の女性の抗NMDA受容体脳炎の２症例、最初の症状が出たそれぞれ２週間と５週間前に、ほくろの切除をしており、
両症例で卵巣奇形腫や他の腫瘍はみつかっていない
ほくろ（色素性母斑）の切除が、抗NMDA受容体脳炎を引き起こす可能性を示唆
Other studies have found both HPV and MCPyV in skin cancers. Falchook and colleagues (2013) [16] reported the presence of HPVMCPyV in a SCC from a patient with melanoma treated with the BRAF inhibitor dabrafenib. In another study involving SCC, Dworkin and colleagues (2009) [13] demonstrated a higher proportion of HPV DNA among the MCPyV-positive group (87%) in comparison to the MCPyV-negative group (57%), although a clear correlation between these two viruses could not be established. Mittledorf and colleagues (2012) [17] reported HPV6 and MCPyV DNA in a combined MCCinvasive SCC. Furthermore, two recent studies have already demonstrated MCPyV DNA in 19 to 37% cervical carcinomas, and one study reported a combined MCC-SCC involving HPV-MCPyV detection in the vulva [18] suggesting that MCPyV might play a role as cofactor to HPV-related cancers [7,8]. It has been suggested that oncoviruses co-infections in tumors might be genetically predisposed. In addition, HPV and MCPyV may cooperate for the development of nonmelanoma skin cancer [14]. Although both hypothesis are possible, a synergic tumorigenic effect is likely due to similarities in genome organization and protein structures of polyomaviruses and papillomaviruses.
メルケル細胞ポリオーマウイルスが、HPV関連がんのコファクターでありそうという報告です。
Objective: This case describes antibody-verified anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis in a previously healthy 7 month-old infant female presenting within 48 hours of receiving an influenza booster vaccination during her first influenza season. Background: A previously healthy 7 month old infant female presented with acute onset of altered mental status, decreased activity, roving eye movements, and opisthotonic posturing within 48 hours of receiving an influenza booster vaccination. She was initially diagnosed with acute demyelinating encephalomyelitis (ADEM) and treated with a short burst of corticosteroids followed by a taper. Symptoms subjectively improved during steroid therapy but did not persist, prompting further diagnostic evaluations. Anti-NMDA receptor encephalitis was confirmed by cerebrospinal fluid antibody titer 68 days after onset of symptoms. Treatment was then undertaken with serial courses of intravenous immunoglobulin (IVIG) and rituximab. The patient’s hospital course was protracted, and she required utilization of intensive care unit resources due to aspiration risk, surgical placement of nutritional and vascular access devices, and paroxysmal autonomic hyperactivity (PAH). Minimal improvement in her neurologic exam was observed at time of hospital discharge and may be due to delayed start of treatment, as well as the cumulative effect of unrecognized seizures early in her illness course. Conclusions: This case describes the youngest patient with anti-NMDA receptor encephalitis yet reported, and the first to suggest correlation with recent influenza vaccination. As higher likelihood of neurologic recovery is associated with early initiation of treatment, providers are encouraged to consider autoimmune neurologic disorders like anti-NMDA receptor encephalitis when mental status abnormalities and developmental regression persist, regardless of patient age.
日本での抗NMDA受容体脳炎 神経内科医のブログ
先日紹介したイギリスの１３歳の女の子（13-year-old girl’s self-diagnosis might have been a life-saver で検索してください）は、
ガーダシルの後に、自己免疫性自律神経節障害と自己診断し、
シドニー大学の先生にメールして、ロンドンの医師を紹介してもらい、診断が確認されています。
シドニー大学の先生の論文（リンク）の症例も、ガーダシル後に発症した１３歳の女の子でしたが、
論文には、ワクチンに関しての記載は全くありませんでした。
自己免疫性自律神経節障害は、中年の男女に発症されることが知られていたようで
シドニー大学の先生の報告は、１３歳という小児での発症が新規性があったということでした。
日本では、サーバリックスの後に筋萎縮性側索硬化症を発症して亡くなった女の子がいます。
これも好発年齢は、４０代から６０代で、男性が女性の２倍ということです。（ウィキペディアから）
サーバリックス後の筋萎縮性側索硬化症は、普通よりも進行が速かったと、神経内科医の先生がおっしゃっていました。
上記のシドニー大学の症例では、自己免疫性自律神経節障害の半分のケースでみつかるという
自己抗体が見つかっていますが、
他の自己抗体も見つかっているようです。
今野先生がどこかで
「副反応は少女たちがもともと持っていたものが出ただけ」とおっしゃたと読みましたが（リンク）、
確かにそうかもしれないケースもありますが
中年になってからでる可能性があったものが
ワクチン後に思春期ででるというのは深刻で重大な問題だと思います。
これを問題だと思わないワクチンを推進している医師の方たちがいるというのも憂慮されることです。
そして、シドニー大学の論文にワクチンのことが書かれていないことも問題です。
さらに言えば、子宮頸がんは、ある程度、リスクグループが特定できます。
網野先生によれば、元吉原の女性たちは、ほとんどが罹患しているようですし、
アメリカでは、リスクの高そうな子だけに推奨している医師もいます。
また、遺伝子の関連も報告されていますし、
ある産婦人科医師がプロジェクトを立ち上げたようですが、その後の更新がないので潰されたのかもしれません。
There is an emerging field within vaccinology called adversomics which acknowledges the fact that adverse reactions after vaccinations may be genetically determined. The last author of many of the papers in this field is none other than Gregory Poland, the editor of the journal Vaccine.
http://www.ncbi.nlm.nih.gov/pubmed/25937189
We have evidence of precisely this in a very recent example: narcolepsy and Pandemrix, one of the pandemic influenza vaccines, in which it was discovered that children with a specific HLA type (DQB1*06:02) elicited a different level of immune response, including autoantibodies which reacted against cells in the CNS responsible for the production of hypocretin.
https://www.ncbi.nlm.nih.gov/pubmed/25501681
There is a suggestion that a similar mechanism is at work in patients who have reported symptoms of dysautonomia after HPV vaccination. There have recently been several girls throughout the world who have tested positive for autoantibodies to the beta 2 adrenergic receptors and the muscarinic 2 receptors and could share a similar HLA type. Letters and reports of this have recently appeared in the scientific literature.
No, there is no current proof that these cases of dysautonomia were caused by the HPV vaccine. However, those of us who work in pharmacovigilance see that these syndromes have been reported more commonly after HPV vaccination than after other vaccines or medications (such as oral contraceptive pills) that are commonly taken in this demographic.
Yes, it is only a hypothesis concerning a potential causal association at the current time. However, our current methodology of safety surveillance relies on both health care providers and patients reporting their suspicions to their regulatory authorities and it is our duty to investigate them. Decisions must then be made to if there is need to further investigate these claims.
The reporting of a similar pattern of symptoms and concerns for dysautonomia have now arisen from a number of geographically distinct locations (the US, Japan, Denmark, Mexico, and Italy). Such observations from different physicians in different locations are considered in the Bradford Hill criteria for causality as "consistency". Such an observation of consistency tends to argue against local reporting bias and could be considered to argue for a growing need to further investigate these reports in a properly designed study.
None of the large safety studies which have been done for HPV vaccines have looked specifically for the outcomes of CRPS or POTS or other forms of dysautonomia. Therefore, using them as references to "debunk" these concerns is simply not possible. Furthermore, syndromes which fall under the umbrella of dysautonomia are largely under-recognised and remain undiagnosed. Therefore, these studies are clearly a challenge.
The future of vaccine safety lies in furthering our understanding of how genetics determines different immune responses and how we might be able to predict which persons will have adverse reactions after vaccination.
Smallpox was eradicated not by vaccinating everyone but rather with a ring vaccination strategy. Identification of those at risk for adverse reactions and adaption of vaccination strategies are possible.
Sustained or even an increased public confidence in vaccines and public health authorities depend on our advancement of vaccine safety science.