•皮疹,発熱が有名だが無症状のことも多い.
•服用開始から数ヶ月〜数年後に発症するものもあり特定はできないことも多い.実際はtrial-and-errorで.
•急性発症のケースでは分かりやすいことが多い(抗けいれん薬や抗菌薬).
•処方薬,OTC,ハーブなどの健康食品すらも原因になりうる.
参考資料
AERS ID:
| 437117 (history) | Vaccinated: | 0000-00-00 | |
| Age: | Onset: | 0000-00-00 | |
| Gender: | Female | Submitted: | 2011-10-06 |
| Location: | Foreign | Entered: | 2011-10-06 |
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TNFαをはじめとする炎症性サイトカインはBBBを構成する血管内皮細胞のtight-junction関連蛋白を低下させ，BBBの機能を障害し，二次的に神経細胞傷害を引き起こすとも書いてあります。
http://catalog.lib.kyushu-u.ac.jp/handle/2324/15514/fam100-7_p243.pdf
総説
ミクログリアによる神経細胞傷害：その機序と対処法について
名古屋大学環境医学研究所 神経免疫
錫村明生
TNFαが間接的に強い神経細胞死を引き起こすと書いてあります。
BBCのニュースから
https://www.youtube.com/watch?v=tF3jZWVc8F8
薬は、
リツキシマブ（Rituximab）は、抗ヒトCD20ヒト・マウスキメラ抗体からなるモノクローナル抗体であり、その製剤は分子標的治療薬のひとつとして抗がん剤・免疫抑制剤などとして使用されている。製剤としてのリツキシマブが注射剤であり、日本はリツキサン（Rituxan）®の商品名で全薬工業[1]および中外製薬から発売されている。
ノルウェーの慢性疲労症候群の患者が、悪性リンパ腫を発症して、その治療にリツキシマブを使用したところ
慢性疲労症候群が改善したことから、ノルウェーで小規模の治験が行われました。
英国の慢性疲労症候群の患者は２５万人程度ということです。
英国では、サーバリックス接種後に、慢性疲労症候群と診断された女の子も多数います。
リツキシマブは、B細胞の表面のCD20という分子を標的とする抗体で、B細胞の癌の治療に使用されていますが、
メモリーB細胞も標的とするので、自己免疫疾患への使用が期待されています。
長谷川稔先生の 総説 B細胞
https://www.jstage.jst.go.jp/article/jsci/28/5/28_5_300/_pdf
松下貴史先生の 総説 図２ にCD20が発現するB細胞の解説あり
https://www.jstage.jst.go.jp/article/jsci/28/5/28_5_333/_pdf
典型的でない抗NMDA受容体抗体脳炎の患者でも、２２人中２１人が免疫療法に応答している
J Neuropsychiatry Clin Neurosci. 2017 Jan 25:appineuropsych16050101. doi: 10.1176/appi.neuropsych.16050101. [Epub ahead of print]
Patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may remain undiagnosed and untreated with immunotherapy. To investigate specific features and responses to immunotherapy of atypical anti-NMDAR antibody positivity patients, the authors reviewed and evaluated previous case reports/series including patients without seizure, involuntary movement, hypoventilation, or tumor. Of 22 patients identified, 21 responded to immunotherapy. Two patients had neurological/motor symptoms with few/no psychiatric/cognitive symptoms, and eight had both. Twelve patients presented with psychiatric/cognitive symptoms with few/no neurological/motor symptoms, and ≥1 had memory impairment, catatonia, abnormal MRI or electroencephalogram results. The authors recommend lumbar puncture and examination of anti-NMDAR antibodies for patients with these features.
抗NMDAR脳炎の患者は、診断されず免疫療法で治療されないでいる可能性がある。
非典型的な抗NMDAR抗体陽性患者の特異的な兆候および免疫療法への応答を調査するために、著者らは、失神、不随意運動、低換気、腫瘍のない患者を含む以前の症例報告を総説し評価した。
２２人の患者が同定され、２１人は免疫療法に応答した。
２人の患者は、精神医学的・認知的症状がほとんどあるいは全くないが神経学的・運動症状を示し、８人の患者は両方を示した。
１２人の患者は、神経学的・運動症状がほとんどあるいは全くないが精神医学的・認知的症状を示し、１人以上が記憶障害、カタトニー（緊張）、MRI異常、または脳波異常の結果があった。
著者らは、これらの兆候を示す患者には、腰椎穿刺および抗NMDAR抗体の検査を推奨する。
KEYWORDS:
Neuroimmunology; Organic Mental Disorders
Anti-NMDA Receptor Encephalitis and Vaccination
Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute autoimmune neurological disorder. The cause of this disease is often unknown, and previous studies revealed that it might be caused by a virus, vaccine or tumor. It occurs more often in females than in males. Several cases were reported to be related to vaccination such as the H1N1 vaccine and tetanus/diphtheria/pertussis and polio vaccines. In this study, we reported an anti-NMDA receptor encephalitis case that may be caused by Japanese encephalitis vaccination. To investigate the association between anti-NMDA receptor encephalitis and vaccination, we analyzed the phylogenetic relationship of the microRNAs, which significantly regulate these vaccine viruses or bacteria, and the phylogenetic relationship of these viruses and bacteria. This reveals that anti-NMDA receptor encephalitis may be caused by Japanese encephalitis vaccination, as well as H1N1 vaccination or tetanus/diphtheria/pertussis and polio vaccinations, from the phylogenetic viewpoint.
抗NMDA受容体脳炎は急性の自己免疫性神経疾患である。
この疾患の原因は不明であることが多いが、以前の研究ではウイルス、ワクチンまたは腫瘍により発症したことが明らかとなっている。いくつかの症例は、H1N1ワクチンやTDPやポリオワクチンなどのワクチン接種との関連が報告されている。本研究では、日本脳炎ワクチンによって発症した可能性のある抗NMDA受容体脳炎の症例を報告する。
抗NMDA受容体脳炎とワクチン接種の関連を検討するために、ワクチンのウイルスやバクテリアを有意に制御するマイクロRNAの系統発生的関連および、これらのウイルスやバクテリアの系統発生的関連を分析した。これにより、系統発生的観点から、抗NMDA受容体脳炎は、日本脳炎ワクチンや、H1N1ワクチンまたはTDPやポリオワクチンによって発症した可能性があることが明らかとなった。
症例抗NMDA受容体脳炎と診断された２歳少女について報告する。日本脳炎ワクチンの２回目接種の１４日後に、低度の発熱（３８．２度）があった。薬を服用してから、１７日目までは良好であった。再び発熱し（３８．８度）、３日間泣き続け嘔吐した。妄想と妄語を含む精神症状が２７日目に顕著となった。血液検査、腹部超音波、x線検査、MRIでは、異常がなかったが、尿道に感染があった。IVIGを投与。３０日目、後弓反張と流涎があり、上方凝視と頸部硬直を示した。ICUへ移転し、ICUで意識喪失と不随意運動を起こした。CSF中に抗NMDAR抗体が検出され、抗NMDA受容体脳炎が確認された。
（ただし、この論文の手法でワクチンと病態を関連付けることは、議論の余地ありらしいです）
The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection.
ガーダシル副反応罹患者の少女や女性を応援する弁護士さんや医師らの努力で、自己免疫疾患と遺伝学のエキスパートによる、利益相反のない正式な調査が行われることになりました。
調査を行うのは
１自己免疫疾患の研究センターのJuan Manuel Anaya Cabrera医師
２心臓血管研究基金のMarcos Lopez医師
Very good morning to all,
After three long years of struggle on behalf of the victims of the vaccine in Colombia, today I am delighted to say that we are close to the investigation seriously and rationally that I requested to the health authorities in Colombia, with groups of physicians specializing in diseases Autoimmune and genetics.
The two researchers that I give you today are recognized not only in Colombia but in the world, its leaves of life and career are indisputable and I have declared their intention to participate in an investigation to establish the damage produced by the gardasil vaccine in our girls and Women, that's why today I can proudly say that the generosity of the medical community without conflict of interest is present in favour of the victims of human papillomavirus vaccine in Colombia.
For the first time in Colombia 2 research groups recognized worldwide are offered to the government authorities and health, to initiate investigations; with these groups we have certainty if the government and political authorities and the health of her condition neutral and Impartial and their high standards in the study of diseases that affect our daughters.
1. Centre for study of autoimmune diseases-creates
Director: Dr. Juan Manuel Anaya Cabrera.
2. Doctor Marcos Lopez, director group of cardiovascular research foundation of Colombia, research group recognized as 1 to the highest level of excellence in research in the world.
http://www.fcv.org/site/investigacion-y-educacion-2/investigacion/grupos-de-investigacion/
Both will offer their ability to initiate investigations in the s affected by the human papillomavirus vaccine of Carmen De Bolivar to the governor of bolivar dumek turbay,
After that, just lack political will and good faith,
! Colombia may be a reference point in the investigation of the side effects of the human papillomavirus vaccine in the population of Carmen De Bolivar! ! Let's make it a reality!
A hug,
Monica Leon DEL Rio
President
Rebuilding Hope association
ポッツ以外にも、過敏性腸症候群、エーラスダンロス症候群、マスト細胞活性化症候群との関連も示唆されています
過敏性腸症候群関連ですが、PATM（自分に対して他人がアレルギー反応を起こす病態）の人の中に過敏性腸症候群の人が多いそうですが、PATMというのはとても悲惨な病態で、若い子に多く、社会生活が成立しなくなってしまうようです。
アメリカのサイトで、PATMになった男の子２人が、発症の前に抗生物質を服用していたと書いていました。
http://www.medhelp.org/posts/People-Allergic-to-Me-PATM/PATM-cure--/show/2901512
そのうちの一人は、Omnicef 2 という抗生物質を発症の２週間前に服用したそうです
統合医療の小西先生のブログでも、http://ameblo.jp/sna10826/entry-11993919267.html PATMについて書かれています。
教えてgooのサイトでの患者さんの投稿
The most common HR-HPVs were HPV16 (29.4%) and HPV52 (11.8%) in the HIV-negativegroup,
HPV52 (22.8%), HPV16 (17.5%), HPV31 and HPV58 (7.0%) in the HIV-positive group.
その他のルワンダの資料
http://www.jstor.org/stable/40254945?seq=1#page_scan_tab_contents
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247865/
High HPV prevalence, incidence and persistence were found among high-risk women in Kigali. HPV52 had the highest incidence; and, together with HPV33 and HPV58, were strongly associated with acquisition of other HR-HPV types in HIV-negative women.
When the bivalent and the quadrivalent HPV vaccines were marketed they were presented as having comparable efficacy against cervical cancer. Differences between the vaccines are HPV types included and formulation of the adjuvant.
A systematic review was conducted to assess the efficacy of the two vaccines against cervical cancer. Outcomes considered were CIN2+, CIN3+, and AIS.
Nine reports (38,419 women) were included. At enrollment mean age of women was 20 years, 90% had negative cytology, and 80% were seronegative and/or DNA negative for HPV 16 or 18 (naïve women). In the TVC-naïve, VE against CIN2+ was 58% (95% CI: 35, 72); heterogeneity was detected, VE being 65% (95% CI: 54, 74) for the bivalent and 43% (95% CI: 23, 57) for the quadrivalent. VE against CIN3+ was 78% (95% CI: <0, 97); heterogeneity was substantial, VE being 93% (95% CI: 77, 98) for the bivalent and 43% (95% CI: 12, 63) for the quadrivalent. VE in the TVC was much lower. No sufficient data were available on AIS.
In naïve girls bivalent vaccine shows higher efficacy, even if the number of events detected is low. In women already infected the benefit of the vaccination seems negligible.
to determine the frequency of human papillomavirus (HPV) types and behavioral characteristics related to cytological abnormalities in women descendants of slaves, who live in isolated communities known as Quilombos in the state of Maranhão, Brazil.
Cervicovaginal specimens of 353 women were analyzed by conventional cytology and genotyping. HPV detection and genotyping was performed using a Linear Array HPV genotyping test kit. Behavioral factors and their association with cytological abnormalities were analyzed as well as the association between cytological abnormalities and HPV infection.
The frequency of HPV infection was 13%, and infection by high-risk HPV types was more frequent than by low-risk types (10.2% versus 2.8%). The most prevalent genotypes were HPV 68 (3.1%) and HPV 58 (2.6%). HPV-positive women were 6.5 times more likely than HPV-negative women to be diagnosed with cytological abnormalities. There was a significant association between HPV infection and the presence of cytological abnormalities in women 31-40 years of age and in women 51-60 years of age.
A distinct profile of high-risk HPV genotypes was detected, with predominance of types 68 and 58. It is possible that the results of the present study are due to specific characteristics of the population, which is geographically isolated and maintains conservative sexual habits.
https://www.youtube.com/watch?v=ewBDkmG6WLM&feature=youtu.be
２０１６年１１月１５日にオランダで放映された、HPVワクチン接種後の病気に関するテレビ番組です
ヨーロッパ中の被害者にインタビューしています。
