Role of Immunogenetics in the Diagnosis of Postvaccinal CNS Pathology

Massimo Montinari*, Biagio Favoino**, and Angela Roberto***
Dept. Of Pediatric Surgery, University of Bari
**Tissue Typing and Organ Transplantation Service, Bari Hospital and Polyclinic
***Virology Outpatient Clinic. Bari Hospital and Polyclinic

Presented in Naples, May 9, 1996, under the auspices of the Associazione per la Libera Universita Internazionale de Medicina Omeopatica "Samuel Hahnemann" (LUIMO). Translated from Italian by Harris L. Coulter, Ph.D.

Resume
This study involves observations of 30 patients with post-vaccinal pathology of the central nervous system and other systems where the first symptoms appeared concomitantly with, or immediately after, administration of a vaccine. All patients were subjected to serologic testing for herpes virus (IgG and IgM) and to HLA (A, B, C) and HLA-DR-DQ tissue typing to see if there was any correlation between the emergence of CNS pathology and these various antigens, thus to show a possible autoimmune-type immunogenetic basis for demyelination processes. Statistical comparison with the Italian population used as controls revealed an increase in the HLA-A3 and HLA-DR7 antigens. The presence of A3 and/or DR-7 was observed in 22/30 (73.3%) of the patients.

Key words
Post-vaccinal pathology; HLA system; autoimmune pathology of the CNS.

Introduction
Post-vaccinal pathology of the central nervous system (CNS) is a topic deserving further investigation. In fact, our own experience with 30 patients of Italian nationality, observed between April, 1994 and October, 1995, shows that clinical signs of CNS pathology -- associated with dermatitis, food allergies, constipation, and leaking from the anus -- emerged concomitantly or immediately after vaccination with the Salk or Sabin polio vaccine, DT, measles, DPT, anti-tuberculosis, or Hepatitis-B vaccines.

The hypothesis of Herroelen, J. De Keyser, and G. Ebinger on "CNS demyelination after immunization with recombinant hepatitis-B vaccine" (Lancet, 338, November 9, 1991, 1174-1175), as verified by A.P. Brezin, M. Lautier-Frau, M. Hamadani, and O. Rogeaux in their article, "Loss of Vision and Eosinophilia after Recombinant Hepatitis-B Vaccine" (Lancet, Italian Edition, April, 1994), suggests the need for a clinical revaluation and a critical look at all the patients observed up to now in Italian and European clinical centers.

Methods
The patients examined by us came from various regions of Italy, and all presented with a clinical history of convulsions concomitantly with, or immediately after, prophylactic vaccinations. We excluded from the study all patients observed by us whose clinical history was not referable to a vaccination. All the patients were subjected to tissue typing for HLA (A, B, C) and HLA DR-DQ with the aim of defining the relative immunogenetic order. The phenotype was defined by a study of various immune functions: lymphocyte subpopulations, serum immunoglobulin content, sphericity of the antibodies to various viruses (CMV, EBV, HSV-1 and HSV-2, VZV).