Abstract
The right environmental trigger can lead to immune system activation, which, in turn, can create an autoimmune reaction. Although each autoimmune disease is characterized by specific symptoms, many nonspecific symptoms can make these conditions difficult to diagnose. In this literature review, we seek an association between immunization-induced uveitis and an autoimmune diagnosis and/or autoimmune flare-up in patients. Our goal is to consider adverse reactions to vaccines as a possible warning sign of current or future autoimmune disease. If an immunization-induced adverse reaction is known to be a predictor of an autoimmune disease, the clinician could raise suspicion for autoimmune disease when a patient presents with vaccine-associated uveitis. While no direct correlations can be made yet, our review supports closer scrutiny of the association of immunizations and autoimmune disorders. The occurrence of uveitis across several autoimmune diseases could mean a possible link between vaccine-induced uveitis and undiagnosed autoimmune disease. Researchers can, therefore, perform retrospective studies on vaccinated patients and investigate the occurrence of uveitis, along with the timeframe of resolution and presenting symptoms at the time of the diagnosis of autoimmune disease.
Highlights
BackgroundDiscovering possible links between vaccines and autoimmune diseases has been an area of inquiry for researchers for many years, but previous studies have largely focused on cause-and-effect relationships [1]
If an immunization-induced adverse reaction is known to be a predictor of an autoimmune disease, the clinician could raise suspicion for autoimmune disease when a patient presents with vaccine-associated uveitis
Spondyloarthropathies have a strong association with human leukocyte antigen (HLA)-B27 [4], while HLA-DR4 shows a higher incidence with rheumatoid arthritis [5]
Summary
Discovering possible links between vaccines and autoimmune diseases has been an area of inquiry for researchers for many years, but previous studies have largely focused on cause-and-effect relationships [1]. The review reveals the hepatitis B vaccine as the most frequent cause of vaccine-associated uveitis [17] Another link between adverse vaccine reactions and their ability to predict autoimmune disease is the existence of “high-risk” HLA proteins in some of the vaccine-induced presentations analyzed here. What they found was the presence of alleles typical of both systemic lupus erythematosus and Sjogren's syndrome, leading them to conclude that the hepatitis B vaccine exacerbated an existing autoimmune disorder or triggered its emergence [28] Their findings strengthen the fundamental argument of this paper and open the door to further research linking adverse vaccination reactions to underlying autoimmune diseases. The hope of this review is to help establish this link so that more patients can receive a timely diagnosis and treatment for their autoimmune diseases Another vaccine triggered condition is called the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) [36]. A patient with an existing undiagnosed or dormant autoimmune disease develops a vaccine-associated adverse reaction, such as uveitis or a localized lupus reaction, which can alert the healthcare provider to perform further testing leading to the discovery of the previously unrecognized autoimmune disease
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