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Vaccination and immunotherapies in neuroimmunological diseases
Nature Reviews Neurology ( IF 38.1 ) Pub Date : 2022-04-06 , DOI: 10.1038/s41582-022-00646-5
Alexander Winkelmann 1 , Micha Loebermann 2 , Michael Barnett 3 , Hans-Peter Hartung 3, 4, 5, 6 , Uwe K Zettl 7
Affiliation  

Neuroimmunological diseases and their treatment compromise the immune system, thereby increasing the risk of infections and serious illness. Consequently, vaccinations to protect against infections are an important part of the clinical management of these diseases. However, the wide variety of immunotherapies that are currently used to treat neuroimmunological disease — particularly multiple sclerosis and neuromyelitis optica spectrum disorders — can also impair immunological responses to vaccinations. In this Review, we discuss what is known about the effects of various immunotherapies on immunological responses to vaccines and what these effects mean for the safe and effective use of vaccines in patients with a neuroimmunological disease. The success of vaccination in patients receiving immunotherapy largely depends on the specific mode of action of the immunotherapy. To minimize the risk of infection when using immunotherapy, assessment of immune status and exclusion of underlying chronic infections before initiation of therapy are essential. Selection of the required vaccinations and leaving appropriate time intervals between vaccination and administration of immunotherapy can help to safeguard patients. We also discuss the rapidly evolving knowledge of how immunotherapies affect responses to SARS-CoV-2 vaccines and how these effects should influence the management of patients on these therapies during the COVID-19 pandemic.



中文翻译:

神经免疫疾病的疫苗接种和免疫疗法

神经免疫疾病及其治疗会损害免疫系统,从而增加感染和严重疾病的风险。因此,预防感染的疫苗接种是这些疾病临床管理的重要组成部分。然而,目前用于治疗神经免疫疾病(尤其是多发性硬化症和视神经脊髓炎谱系疾病)的多种免疫疗法也会削弱对疫苗接种的免疫反应。在这篇综述中,我们讨论了已知的各种免疫疗法对疫苗免疫反应的影响,以及这些影响对于神经免疫疾病患者安全有效地使用疫苗意味着什么。接受免疫治疗的患者接种疫苗的成功很大程度上取决于免疫治疗的具体作用方式。为了在使用免疫疗法时最大限度地降低感染风险,在开始治疗之前评估免疫状态并排除潜在的慢性感染是必不可少的。选择所需的疫苗接种并在疫苗接种和免疫治疗之间留出适当的时间间隔有助于保护患者。我们还讨论了关于免疫疗法如何影响对 SARS-CoV-2 疫苗的反应以及这些影响如何影响在 COVID-19 大流行期间对这些疗法患者的管理的快速发展的知识。在开始治疗之前评估免疫状态和排除潜在的慢性感染是必不可少的。选择所需的疫苗接种并在疫苗接种和免疫治疗之间留出适当的时间间隔有助于保护患者。我们还讨论了关于免疫疗法如何影响对 SARS-CoV-2 疫苗的反应以及这些影响如何影响在 COVID-19 大流行期间对这些疗法患者的管理的快速发展的知识。在开始治疗之前评估免疫状态和排除潜在的慢性感染是必不可少的。选择所需的疫苗接种并在疫苗接种和免疫治疗之间留出适当的时间间隔有助于保护患者。我们还讨论了关于免疫疗法如何影响对 SARS-CoV-2 疫苗的反应以及这些影响如何影响在 COVID-19 大流行期间对这些疗法患者的管理的快速发展的知识。

更新日期:2022-04-06
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