Potential mechanisms of anaphylaxis to COVID-19 mRNA vaccines

Autor: Robert A. Wood, Amy P. Stallings, Frederic F. Little, Donna S. Hummell, Joshua D. Milner, Allison E. Norton, Kathryn M. Edwards, Kimberly A. Risma
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Allergy
mast cells
LNP
Lipid nanoparticle
C5a
Complement component 5a
0302 clinical medicine
Risk Factors
Immunology and Allergy
Medicine
PEGylated
Polyethlene glycol conjugated
COVID-19
Coronavirus disease 2019
biology
Effector
lipid nanoparticle
DC
Dendritic cell
Lipids
mRNA
Messenger RNA
PEGylated liposome
PEG
Polyethylene glycol
BAT
Basophil activation test
polyethylene glycol
Antibody
Anaphylaxis
2019-nCoV Vaccine mRNA-1273
COVID-19 Vaccines
Immunology
Article
Drug Hypersensitivity
03 medical and health sciences
anaphylaxis
Animals
Humans
RNA
Messenger
Messenger RNA
Fc
Fragment crystallizable region
business.industry
SARS-CoV-2
BST
Basal serum tryptase
COVID-19
Dendritic cell
medicine.disease
allergy
030104 developmental biology
mRNA vaccine
C3a
Complement component 3a
030228 respiratory system
HMW
High-molecular-weight
Nucleic acid
biology.protein
Nanoparticles
business
Complement component 5a
COVID-19 vaccine
Zdroj: The Journal of Allergy and Clinical Immunology
ISSN: 1097-6825
0091-6749
Popis: Anaphylaxis to vaccines is historically a rare event. The coronavirus disease 2019 pandemic drove the need for rapid vaccine production applying a novel antigen delivery system: messenger RNA vaccines packaged in lipid nanoparticles. Unexpectedly, public vaccine administration led to a small number of severe allergic reactions, with resultant substantial public concern, especially within atopic individuals. We reviewed the constituents of the messenger RNA lipid nanoparticle vaccine and considered several contributors to these reactions: (1) contact system activation by nucleic acid, (2) complement recognition of the vaccine-activating allergic effector cells, (3) preexisting antibody recognition of polyethylene glycol, a lipid nanoparticle surface hydrophilic polymer, and (4) direct mast cell activation, coupled with potential genetic or environmental predispositions to hypersensitivity. Unfortunately, measurement of anti–polyethylene glycol antibodies in vitro is not clinically available, and the predictive value of skin testing to polyethylene glycol components as a coronavirus disease 2019 messenger RNA vaccine-specific anaphylaxis marker is unknown. Even less is known regarding the applicability of vaccine use for testing (in vitro/vivo) to ascertain pathogenesis or predict reactivity risk. Expedient and thorough research-based evaluation of patients who have suffered anaphylactic vaccine reactions and prospective clinical trials in putative at-risk individuals are needed to address these concerns during a public health crisis.
Databáze: OpenAIRE
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