Title: Immunological hazards associated with human immunization with self or self-like antigens.

POPLINE Document Number: 075896

Author(s):

Rose NR
Wick G
Berger P
Ada GL

Source citation:

In: Vaccines for fertility regulation: the assessment of their safety and efficacy. Proceedings of a Symposium on Assessing the Safety and Efficacy of Vaccines to Regulate Fertility, convened by the WHO Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, June 1989, edited by G.L. Ada, P.D. Griffin. Cambridge, England, Cambridge University Press, 1991. :121-46. (Scientific Basis of Fertility Regulation)

Abstract:

This review of autoimmune disorders as applied to clinical trials of vaccines describes the physiology of autoimmunity, types of autoimmune targets, types of autoimmune disorders, antigens of the reproductive system, and assessment of autoimmune disorders in clinical trial subjects. After a brief summary of the mechanism of the immune response, theories of deletion of anti-self-antibodies are considered. Clonal deletion of B-cells specific for major self-antigens, if not all self-antigens, and elimination of T-cells with high affinity receptors for self-antigens, are likely. There may be antigen-specific suppressor T-cells, or anti-idiotype mechanisms that prevent autoimmune responses. Autoimmunity can develop to circulating antigens, internal constituents of cells, cell-surface antigens, and sequestered antigens. The most likely antigens in the reproductive tract useful for contraceptive vaccines are gonadotropins, sperm antigens, sperm lactic dehydrogenase isomer-4, and zona pellucida. The general types of autoimmune damage due to antibody-mediated reactions are circulating immune complex diseases such as glomerular nephritis, Arthus reaction, and serum sickness. There also can be cytotoxic antibody disorders and cell-mediated immune disorders. An explanation and an algorithm for assessment of the immune system in subjects participating in trials of vaccines are provided. The general scheme is to screen for autoantibodies, then to determine the cell type and Ig class of antibody, and then determine the cellular location by immuno-electron microscopy. It would be prudent in human trials also to identify each individual's HLA phenotype for future reference in case of unexpected autoimmune reactions.

Keywords:

Literature Review
Recommendations
Physiology
Cytologic Effects
Gonadotropins
Gonadotropins, Chorionic
Immunoglobulin Alterations
Immunity, Cellular
Immunity, Active
Immunity, Natural
Antibodies
Antibody Formation
Antigen-Antibody Reactions
Autoantibodies
Rheumatoid Factor
Autoimmune Response
Immunological Effects
Genital Effects, Female
Laboratory Examinations and Diagnoses
Hormones
Vaccines
Biology
Endocrine System
Hematological Effects
Hemic System
Immunity
Immune System
Immunologic Factors
Genitalia, Female
Genitalia
Urogenital System
Examinations and Diagnoses