Can Hib Vaccine Cause Asthma?

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Can Hib Vaccine Cause Asthma?

http://www.vaccination.org.uk/vaccines/hib2.html

Can Hib Vaccine Cause Asthma?

by Heidi White

Can the Haemophilus influenzae type b (Hib) vaccine cause asthma or

allergy? I am not aware of any human studies that have specifically looked

at the effect of Hib vaccine on asthma. However, a Swiss study1 found that

invasive Hib infection (epiglottitis) could possibly be linked to an

increase in the rate of asthma and allergies (OR 4.8). There may be a few

explanations for this. Firstly, the treatment of a Hib infection with

antibiotics, such as cephalosporins (eg cefotaxime or ceftriaxone), may by

itself increase the risk of asthma.2 And secondly, cell wall components

from the Hib bacteria may also be a cause of asthma.

If invasive Hib infection is able to cause asthma then it may also be

possible that the Hib vaccine could also have a similar effect. Animal

studies have provided various mechanisms for why this could occur:

a) A nasal Hib vaccine has been shown to stimulate Th1 and Th2 cells in

mice.3 If the Th2 side of the immune system is over stimulated, then this

can increase the risk of asthma and allergy.

Hib vaccination in rats has been shown to enhance histamine levels with

a corresponding increase in the number of eosinophils.4-7 Eosinophils

(white blood cells, used to fight infection) will proliferate and

accumulate in the airways under stimulation by interleukin-5 (IL-5), a

cytokine produced by Th2 cells. Eosinophil accumulation is also evident in

the dermis of the skin seen in people with atopic dermatitis (eczema).

c) Hib vaccination in rats has been shown to cause increased

bronchoconstriction in response to histamine, possibly due to an increased

reactivity of the para-sympathetic/cholinergic pathways.7,8

d) Studies in guinea-pigs have shown that Hib vaccination may impair the

beta (b ) 2-adrenergic system by causing a blocking or desensitization of b

2 receptors, or by reducing the number of b 2 receptors in the lung.9-13

Inhibition of b receptors can lead to increased bronchoconstriction. It is

thought that the polysaccharide component of the bacterial cell wall may be

responsible for this effect.14 HibTitre vaccine contains purified

polysaccharide (PRP), from the capsule of the Hib bacteria, which is linked

to a diphtheria carrier protein. PedvaxHIB vaccine contains PRP linked to a

meningococcal protein.

It would be interesting to see the results of a human study that

specifically examines the effects of Hib vaccine on the incidence of asthma

and allergy.

Heidi White

Hospital Pharmacist

September, 1999.

REFERENCES:

1. Muhlemann K et al. Risk factors for invasive Haemophilus influenzae

disease among children 2-16 years of age in the vaccine era, Switzerland

1991-1993. The Swiss H. Influenzae Study Group. Int J Epidemiol 1996

Dec;25(6):1280-5

2. Farooqi IS, Hopkin MH. Early childhood infection and atopic disorder.

Thorax 1998 November; 53: 927-932

3. Kurono Y et al. Nasal immunization induces Haemophilus

influenzae-specific Th1 and Th2 responses with mucosal IgA and systemic IgG

antibodies for protective immunity. J Infect Dis 1999 Jul;180(1):122-32

4. Nijkamp FP et al. Facilitation of histamine release in the

Haemophilus influenzae vaccinated experimental animal. Br J Pharmacol. 1980

Jan; 68(1):147P

5. Raaijmakers JA, Terpstra GK, Kreukniet J. Mast cells as a possible

source of Haemophilus influenzae-induced changes in plasma and lung

histamine levels. Int Arch Allergy Appl Immunol 1980;61(3):352-7

6. Terpstra GK, Raaijmakers JA; Kreukniet J. Comparison of vaccination

of mice and rats with Haemophilus influenzae and Bordetella pertussis as

models of atopy. Clin Exp Pharmacol Physiol 1979 Mar-Apr;6(2):139-49

7. Terpstra GK et al. Effects of Haemophilus influenzae vaccination on

the (para-)sympathic- cyclic nucleotide-histamine axis in rats. Ann Allergy

1979 Jan; 42(1):36-40

8. Schreurs AJ, Nijkamp FP. Bronchial hyper-reactivity to histamine

induced by Haemophilus influenzae vaccination. Agents Actions 1984 Oct;

15(3-4): 211-5

9. Terpstra GK, Kreukniet J, Raaijmakers JA. Changes in beta-adrenergic

responses as a consequence of infection with micro-organisms. Eur J Respir

Dis Suppl 1984;135:34-46

10. Schreurs AJ, Terpstra GK et al. The effects of Haemophilus influenzae

vaccination on anaphylactic mediator release and isoprenaline-induced

inhibition of mediator release. Eur J Pharmacol 1980 Apr 4;62(4):261-8

11. Schreurs AJ, Versteeg DH, Nijkamp FP. Involvement of catecholamines

in Haemophilus influenzae induced decrease of beta-adrenoceptor function.

Naunyn Schmiedebergs Arch Pharmacol 1982 Sep; 320(3):235-9

12. Schreurs AJ, Terpstra GK, Raaijmakers JA, Nijkamp FP. Effects of

vaccination with Haemophilus influenzae on adrenoceptor function of

tracheal and parenchymal strips. J Pharmacol Exp Ther 1980 Dec;215(3):691-6

13. Nijkamp FP et al. Inhibition of effects of isoprenaline and

adrenaline by Haemophilus influenzae vaccination. Br J Pharmacol. 1980 Jan;

68(1):146P.

14. Schreurs AJ, Verhoef J, Nijkamp FP. Bacterial cell wall components

decrease the number of guinea-pig lung beta-adrenoceptors. Eur J Pharmacol

1983 Jan 28; 87(1):127-32

Journal articles--Hib vaccine & asthma

[Vaccination]

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Sheri Nakken, former R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

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