流感疫苗接种引起发作性睡病

Narcolepsy caused by A( H1N1) pandemic vaccine inoculation

在2009年全球A(H1N1)流感病毒大流行期间,多种A(H1N1)大流行流感疫苗被批准应用。一种以AS03-为佐剂的A(H1N1)大流行流感疫苗(Pandemrix)被应用于47个国家,达3 100万剂。在应用一年后,开始出现接种Pandemrix疫苗所引起的发作性睡病的报道。发作性睡病是一种尚无治疗方法的疾病,主要症状表现是患者在白天常发生不可自控的睡眠。报道首先来自于瑞士,然后丹麦,继而欧洲的许多国家。迄今为止,已有1 300多人因接种Pandemrix疫苗发生了发作性睡病,生产Pandemrix疫苗的葛兰素史克(Glaxo Smith-Kline,GSK)公司已承认了两者间的关联。2015年7月1日,科学转化医学杂志的一篇文章揭示Pandemrix疫苗中的流感病毒核蛋白刺激所产生的抗体可以和人下丘脑泌素受体2发生交叉反应,表明Pandemrix疫苗激发的自身免疫反应是其引起发作性睡病的主因,提示有必要显著减少或去除流感病毒疫苗中的流感病毒核蛋白。

With a global A（H1N1） influenza pandemic in 2009, A（H1N1） pandemic vaccines were developed with differ-ent technologies and licensed.Among the vaccines, a AS03-adjuvanted A（ H1N1） pandemic vaccine with Pandemrix as its commercial name was distributed and used up to 31 million doses in more than 47 countries[1] .One year after its applica-tion, narcolepsy, an incurable, debilitating condition that causes overpowering daytime sleepiness, began to be correlated with the Pandemrix inoculation, firstly in Swiss conferderation, then in Denmark, followed in other European countries.Up to now, more than 1 300 people who received the Pandemrix have developed narcolepsy, and the manufacturer, Glaxo-SmithK-line （ GSK）, has acknowledged the link [1] .On July 1 this year, a paper[2] in Science Translational Medicine shows that nucleoprotein in the Pandemrix triggers antibodies that cross-react with human hypocretin receptor 2 in brain cells that help to regulate sleepiness.The work strongly suggests that the Pandemrix triggers an autoimmune reaction that leads to narcolepsy, and that keeping the nucleoprotein levels low or removing the protein are the ways to make influenza vaccines safer.