Only 33.8% of those born after 1981-1990 have vaccine-induced IgG levels considered protective of rubella.

PMID: 

Vaccine. 2015 Jan 29 ;33(5):635-41. Epub 2014 Dec 19. PMID: 25533327

Abstract Title: 

Determining rubella immunity in pregnant Alberta women 2009-2012.

Abstract: 

Rubella IgG levels for 157,763 pregnant women residing in Alberta between 2009 and 2012 were analyzed. As there have been no reported cases of indigenous rubella infection in Canada since 2005, there has been a lack of naturally acquired immunity, and the current prenatal population depends almost entirely on vaccine induced immunity for protection. Rubella antibody levels are significantly lower in younger maternal cohorts with 16.8% of those born prior to universal vaccination programs (1971-1980), and 33.8% of those born after (1981-1990) having IgG levels that are not considered protective (

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Some rubella vaccinees never reach or maintain protective antibody levels. This may be explained by polymorphisms in the HLA-DPB1 gene.

PMID: 

J Infect Dis. 2015 Mar 15 ;211(6):898-905. Epub 2014 Oct 6. PMID: 25293367

Abstract Title: 

Polymorphisms in HLA-DPB1 are associated with differences in rubella virus-specific humoral immunity after vaccination.

Abstract: 

Vaccination with live attenuated rubella virus induces a strong immune response in most individuals. However, small numbers of subjects never reach or maintain protective antibody levels, and there is a high degree of variability in immune response. We have previously described genetic polymorphisms in HLA and other candidate genes that are associated with interindividual differences in humoral immunity to rubella virus. To expand our previous work, we performed a genome-wide association study (GWAS) to discover single-nucleotide polymorphisms (SNPs) associated with rubella virus-specific neutralizing antibodies. We identified rs2064479 in the HLA-DPB1 genetic region as being significantly associated with humoral immune response variations after rubella vaccination (P = 8.62× 10(-8)). All other significant SNPs in this GWAS were located near the HLA-DPB1 gene (P ≤ 1 × 10(-7)). These findings demonstrate that polymorphisms in HLA-DPB1 are strongly associated with interindividual differences in neutralizing antibody levels to rubella vaccination and represent a validation of our previous HLA work.

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Certain single-nucleotide polymorphisms are associated with immune responses to measles and rubella vaccines.

PMID: 

Immunogenetics. 2014 Nov ;66(11):663-9. Epub 2014 Aug 21. PMID: 25139337

Abstract Title: 

Single-nucleotide polymorphism associations in common with immune responses to measles and rubella vaccines.

Abstract: 

Single-nucleotide polymorphisms (SNPs) in candidate immune response genes were evaluated for associations with measles- and rubella-specific neutralizing antibodies, interferon (IFN)-γ, and interleukin (IL)-6 secretion in two separate association analyses in a cohort of healthy immunized subjects. We identified six SNP associations shared between the measles-specific and rubella-specific immune responses, specifically neutralizing antibody titers (DDX58), secreted IL-6 (IL10RB,IL12B), and secreted IFN-γ (IFNAR2, TLR4). An intronic SNP (rs669260) in the antiviral innate immune receptor gene, DDX58, was significantly associated with increased neutralizing antibody titers for both measles and rubella viral antigens post-MMR vaccination (p values 0.02 and 0.0002, respectively). Significant associations were also found between IL10RB (rs2284552; measles study p value 0.006, rubella study p value 0.00008) and IL12B (rs2546893; measles study p value 0.005, rubella study p value 0.03) gene polymorphisms and variations in both measles- and rubella virus-specific IL-6 responses. We also identified associations between individual SNPs in the IFNAR2 and TLR4 genes that were associated with IFN-γ secretion for both measles and rubella vaccine-specific immune responses. These results are the first to indicate that there are SNP associations in common across measles and rubella vaccine immune responses and that SNPs from multiple genes involved in innate and adaptive immune response regulation may contribute to the overall human antiviral response.

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A case report of fatal encephalitis asssociated with the measles rubella vaccine.

PMID: 

J Clin Virol. 2013 Dec ;58(4):737-40. Epub 2013 Oct 24. PMID: 24216323

Abstract Title: 

Fulminant encephalitis associated with a vaccine strain of rubella virus.

Abstract: 

Involvement of the central nervous system is common in measles, but rare in rubella. However, rubella virus (RV) can cause a variety of central nervous system syndromes, including meningitis, encephalitis, Guillain-Barré syndrome and sub acute sclerosing panencephalitis. We report the occurrence of one fatal case of the encephalitis associated with measles-rubella (MR) vaccine during an immunization campaign in São Paulo, Brazil. A 31 year-old-man, previously in good health, was admitted at emergency room, withconfusion, agitation, inability to stand and hold his head up. Ten days prior to admission, he was vaccinated with combined MR vaccine (Serum Institute of India) and three days later he developed 'flu-like' illness with fever, myalgia and headache. Results of clinical and laboratory exams were consistent with a pattern of viral encephalitis. During hospitalization, his condition deteriorated rapidly with tetraplegia and progression to coma. On the 3rd day of hospitalization he died. Histopathology confirmed encephalitis and immunohistochemistry was positive for RV on brain tissue. RV was alsodetected by qPCR and virus isolation in cerebrospinal fluid, brain and other clinical samples. The sequence obtained from the isolated virus was identical to that of the RA 27/3 vaccine strain.

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The rubella vaccine causes both arthralgias and arthritis in 10–40% of susceptible females. Of note, some develop persistent joint reactions.

PMID: 

Paediatr Child Health. 2009 Dec ;19(Suppl 2):S156-S159. PMID: 20976024

Abstract Title: 

Genetic basis for variation of vaccine response: our studies with rubella vaccine.

Abstract: 

Congenital rubella syndrome still occurs throughout the world despite an effective vaccine being used in developed countries. Heat and light lability, as well as contraindications in immunocompromised persons, limit the use of the vaccine. An improved, more durable and less reactive rubella vaccine such as a peptide or subunit vaccine would address these unmet needs. We have sought to identify the genetic factors that influence both humoral and cell-mediated immunity. Specifically, we have examined genetic polymorphisms and their associations with variations in the immune response to rubella vaccine. Our previous work with twins has identified substantial heritability with rubella vaccine antibody response. We have since identified human leukocyte antigen associations, with both humoral (class II) and cellular (class I) immunity. Our preliminary work with genetic determinants in cytokines and their receptors have offered tantalising leads as well. Now, having recruited a larger cohort to combine with our previous sample, we lay out in this paper our specific aims for a larger, more comprehensive study of the genetic associations with rubella vaccine response and components of both humoral and cellular immunity.

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Epigallocatechin gallate inhibits the HIV reverse transcription step.

PMID: 

Antivir Chem Chemother. 2011 Jul 4 ;21(6):239-43. Epub 2011 Jul 4. PMID: 21730371

Abstract Title: 

Epigallocatechin gallate inhibits the HIV reverse transcription step.

Abstract: 

BACKGROUND: Epigallocatechin gallate (EGCG), the most abundant catechin in green tea, has been reported to inhibit HIV-1 replication prior to its integration into host DNA via various proposed mechanisms; however, the specific main target(s) of EGCG remain unclear. In this study, we investigated a number of these proposed detailed mechanism(s) using a cell-based model.METHODS: Multinuclear activation of galactosidase indicator assays were used for all experiments, including examination of the time of addition and the synergisms with a nucleoside reverse transcriptase inhibitor, 3'-azido-3'-deoxythymidine (AZT).RESULTS: The experiments revealed that EGCG suppressed both HIV-1(IIIB) and HIV-2(EHO) infection in HeLa-CD4-LTR-β-gal cells, with relatively low 50% effective concentrations of 1.6 and 2.0 μM, respectively. The inhibitory profile of EGCG generated using a time-of-addition assay was identical to that of a non-nucleoside reverse transcriptase inhibitor (NNRTI), MKC-442. Furthermore, synergistic inhibition wasobserved in EGCG with AZT.CONCLUSIONS: Based on our findings, EGCG appears to act mainly as an allosteric reverse transcriptase inhibitor with mechanisms different from those of currently approved NNRTIs that directly interact with the NNRTI binding pocket. Thus, EGCG is a good candidate for use as an additional or supportive anti-HIV agent derived from natural plants.

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A case report of systemic juvenile idiopathic arthritis relapse after rubella vaccination.

PMID: 

Vaccine. 2009 Aug 13 ;27(37):5041-2. Epub 2009 Jul 2. PMID: 19576941

Abstract Title: 

A relapse of systemic type juvenile idiopathic arthritis after a rubella vaccination in a patient during a long-term remission period.

Abstract: 

An 11-year-old female patient, whose systemic type juvenile idiopathic arthritis (JIA) had maintained in remission for the previous 4 years while taking only a small amounts of ibuprofen, showed an abrupt 2nd relapse with congestive heart failure five days after receiving a live-attenuated rubella vaccine, which was a primary immunization. Her serum levels of anti-rubella IgM and IgG antibodies increased, and her laboratory findings such as a leukocytosis, elevated serum levels of CRP, IL-6 and other inflammatory cytokine profiles were similar to the findings observed during her previous JIA active stage. After being administration of co-therapy with steroid pulse, ibuprofen, methotrexate and phosphodiesterase inhibitor gradually improved her clinical symptoms such as spiky fever, heart failure and arthralgia. Her intermittent fever and increased serum levels of CRP and IL-6, however, have been sustained for more than 2 years, and this prolonged active clinical course therefore differed from her previous JIA active stage.This abrupt relapse only five days after vaccination was suggested not to be directly related with rubella infection, but instead to be related with the molecular mimicry between rubella and JIA.

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A case report of complex regional pain syndrome type-I after rubella vaccination.

PMID: 

Coll Antropol. 2013 Sep ;37(3):1015-8. PMID: 24308253

Abstract Title: 

Complex regional pain syndrome type I after diphtheria-tetanus (Di-Te) vaccination.

Abstract: 

Complex regional pain syndrome type I (CRPS I) is a disorder of one or more extremities characterized by pain, abnormal sensitivity (allodynia), swelling, limited range of motion, vasomotor instability, fatigue and emotional distress. The symptoms may be aggravated by even minor activity or weather change. It is usually provoked by injury, surgery or injection but in a small proportion of patients CRPS I develops without a clear causative event. There are several literature reports on CRPS after rubella and hepatitis B vaccination. We present a case of CRPS I affecting the left arm after diphtheria and tetanus (Di-Te) vaccination in the left deltoid muscle in a young girl having experienced profound emotional stress before the vaccination procedure. History data on previous minor trauma at the site of vaccination or emotional stress may necessitate temporary vaccination delay due to their proneness to impaired local or systemic immune response and CRPS as a complication of vaccination. If a child or an adult has prominent swelling and severe pain after vaccination, the diagnosis of CRPS I should be considered and if confirmed, the multidisciplinary treatment should start as soon as possible.

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The Institute of Medicine reported a causal relationship between the rubella vaccine and acute and chronic arthritis.

PMID: 

Clin Exp Rheumatol. 2001 Nov-Dec;19(6):724-6. PMID: 11791647

Abstract Title: 

Rubella vaccine and arthritic adverse reactions: an analysis of the Vaccine Adverse Events Reporting System (VAERS) database from 1991 through 1998.

Abstract: 

OBJECTIVE: The United States Academy of Sciences, Institute of Medicine (IOM) reported in 1991 that the evidence indicates a causal relationship between the currently used rubella vaccine and acute and chronic arthritis. The purpose of this study was to analyze the associated arthritic reactions reported following rubella immunization from 1991 through 1998 to the Vaccine Adverse Events Reporting System (VAERS) database.METHODS: A certified copy of the VAERS database was obtained from the CDC. Microsoft Access was used to analyze the database.RESULTS: The results show that rubella vaccine is associated with a number of arthritic reactions reported to the VAERS database.CONCLUSION: Adult female patients need to make informed decisions on whether or not rubella vaccination is right for them. Doctors and patients must together make an informed consent decision about the risk verses the benefit to the patient in their particular life situation. Additionally, those patients who have had an adverse reaction to rubella vaccination should be informed that they may seek compensation under the no-fault Vaccine Compensation Act, which is administered by the US Claims Court.

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A case report of acute disseminated myelitis following live rubella vaccination.

PMID: 

Brain Dev. 2000 Jun ;22(4):259-61. PMID: 10838115

Abstract Title: 

Acute disseminated encephalomyelitis after live rubella vaccination.

Abstract: 

We report here a case involving a 14-year-old boy who developed acute disseminated encephalomyelitis following live rubella vaccination. The patient became febrile and began to experience nuchal pain 16 days after the immunization. By 22 days after immunization, he experienced difficulty in walking. By 24 days, he had developed tetraparesis with retention of urine, and total sensory loss below the Th1 dermatomal level. He was febrile at this point and showed nuchal rigidity and Lhermitte's sign. Cerebrospinal fluid examination revealed elevated cell counts, protein level, and myelin basic protein. T2-weighted magnetic resonance imaging detected high intensity lesions in the bilateral cerebral white matter and cervical spinal cord. Following the administration of intravenous corticosteroids, the patient's clinical symptoms improved rapidly.

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