Abstract
A prospective study was carried out to correlate the development of joint symptoms after rubella immunization with pre- and post-immunization rubella-specific immunological responses. Arthralgia or arthritis or both occurred in 10 of 37 adult female volunteers at a mean time of 17.0 days after immunization with the RA 27/3 rubella vaccine. All individuals studied before immunization were seronegative for rubella by either the hemagglutination inhibition or the single radial hemolysis technique. In contrast, rubella enzyme-linked immunosorbent assay or lymphoproliferative responses or both were positive in 27 of 37 (73%) individuals tested before receiving the vaccine. Rubella enzyme-linked immuno-sorbent assays carried out before immunization were positive at high levels (mean E = 0.536) in four individuals who developed recurrent episodes of arthritis after administration of the vaccine while remaining at low levels preimmunization in subjects who developed transient arthralgia (E = 0.238) or no joint manifestations at all (E = 0.288). These data provide preliminary evidence suggesting that rubella vaccine-associated arthritis may occur as a consequence of secondary, rather than primary, infection with rubella virus and that the presence of circulating, nonneutralizing rubella antibody may enhance the development or severity (or both) of the associated postinfection joint manifestations. Assessment of rubella hemagglutination inhibition, hemagglutination inhibition (immunoglobulin M), and enzyme-linked immunosorbent assay serological responses at 6 weeks and 6 months post-immunization revealed no significant differences between patients who developed and those who did not develop joint manifestations. Rubella lymphoproliferative responses were elevated at 6 weeks post-immunization in the group developing arthralgia or arthritis or both, with no difference between the groups observed at 6 months post-immunization.
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Selected References
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- Best J. M., Banatvala J. E., Bowen J. M. New Japanese rubella vaccine: comparative trials. Br Med J. 1974 Jul 27;3(5925):221–224. doi: 10.1136/bmj.3.5925.221. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buimovici-Klein E., O'Beirne A. J., Millian S. J., Cooper L. Z. Low level rubella immunity detected by ELISA and specific lymphocyte transformation. Arch Virol. 1980;66(4):321–327. doi: 10.1007/BF01320628. [DOI] [PubMed] [Google Scholar]
- Chantler J. K., Ford D. K., Tingle A. J. Persistent rubella infection and rubella-associated arthritis. Lancet. 1982 Jun 12;1(8285):1323–1325. doi: 10.1016/s0140-6736(82)92398-4. [DOI] [PubMed] [Google Scholar]
- Chantler J. K., Ford D. K., Tingle A. J. Rubella-associated arthritis: rescue of rubella virus from peripheral blood lymphocytes two years postvaccination. Infect Immun. 1981 Jun;32(3):1274–1280. doi: 10.1128/iai.32.3.1274-1280.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chiba Y., Sadeghi E., Ogra P. L. Abnormalities of cellular immune response in arthritis induced by rubella vaccination. J Immunol. 1976 Nov;117(5 Pt 1):1684–1687. [PubMed] [Google Scholar]
- Cooper L. Z., Ziring P. R., Weiss H. J., Matters B. A., Krugman S. Transient arthritis after rubella vaccination. Am J Dis Child. 1969 Aug;118(2):218–225. doi: 10.1001/archpedi.1969.02100040220011. [DOI] [PubMed] [Google Scholar]
- Coyle P. K., Wolinsky J. S., Buimovici-Klein E., Moucha R., Cooper L. Z. Rubella-specific immune complexes after congenital infection and vaccination. Infect Immun. 1982 May;36(2):498–503. doi: 10.1128/iai.36.2.498-503.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fogel A., Moshkowitz A., Rannon L., Gerichter C. B. Comparative trials of RA 27-3 and Cendehill rubella vaccines in adult and adolescent females. Am J Epidemiol. 1971 May;93(5):392–398. doi: 10.1093/oxfordjournals.aje.a121272. [DOI] [PubMed] [Google Scholar]
- Ford D. K., Tingle A. J. Cell-mediated immune responses in patients with recurrent arthritis following rubella immunization. J Rheumatol. 1980 Mar-Apr;7(2):225–230. [PubMed] [Google Scholar]
- Grahame R., Armstrong R., Simmons N. A., Mims C. A., Wilton J. M., Laurent R. Isolation of rubella virus from synovial fluid in five cases of seronegative arthritis. Lancet. 1981 Sep 26;2(8248):649–651. doi: 10.1016/s0140-6736(81)90993-4. [DOI] [PubMed] [Google Scholar]
- Halstead S. B. In vivo enhancement of dengue virus infection in rhesus monkeys by passively transferred antibody. J Infect Dis. 1979 Oct;140(4):527–533. doi: 10.1093/infdis/140.4.527. [DOI] [PubMed] [Google Scholar]
- Halstead S. B., O'Rourke E. J. Dengue viruses and mononuclear phagocytes. I. Infection enhancement by non-neutralizing antibody. J Exp Med. 1977 Jul 1;146(1):201–217. doi: 10.1084/jem.146.1.201. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ogra P. L., Chiba Y., Ogra S. S., Dzierba J. L., Herd J. K. Rubella-virus infection in juvenile rheumatoid arthritis. Lancet. 1975 May 24;1(7917):1157–1161. doi: 10.1016/s0140-6736(75)93136-0. [DOI] [PubMed] [Google Scholar]
- Ogra P. L., Herd J. K. Arthritis associated with induced rubella infection. J Immunol. 1971 Sep;107(3):810–813. [PubMed] [Google Scholar]
- Peiris J. S., Porterfield J. S. Antibody-mediated enhancement of Flavivirus replication in macrophage-like cell lines. Nature. 1979 Nov 29;282(5738):509–511. doi: 10.1038/282509a0. [DOI] [PubMed] [Google Scholar]
- Prabhakar B. S., Nathanson N. Acute rabies death mediated by antibody. Nature. 1981 Apr 16;290(5807):590–591. doi: 10.1038/290590a0. [DOI] [PubMed] [Google Scholar]
- Rammohan K. W., McFarland H. F., McFarlin D. E. Induction of subacute murine measles encephalitis by monoclonal antibody to virus haemagglutinin. Nature. 1981 Apr 16;290(5807):588–589. doi: 10.1038/290588a0. [DOI] [PubMed] [Google Scholar]
- Russell S. M., Benjamin S. R., Briggs M., Jenkins M., Mortimer P. P., Payne S. B. Evaluation of the single radial haemolysis (SRH) technique for rubella antibody measurement. J Clin Pathol. 1978 Jun;31(6):521–526. doi: 10.1136/jcp.31.6.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith M. F., Haycock G. B., Grahame R. Rubella and juvenile chronic arthritis. Arch Dis Child. 1981 Apr;56(4):310–311. doi: 10.1136/adc.56.4.310. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spruance S. L., Metcalf R., Smith C. B., Griffiths M. M., Ward J. R. Chronic arthropathy associated with rubella vaccination. Arthritis Rheum. 1977 Mar;20(2):741–747. doi: 10.1002/art.1780200216. [DOI] [PubMed] [Google Scholar]
- Thompson G. R., Ferreyra A., Brackett R. G. Acute arthritis complicating rubella vaccination. Arthritis Rheum. 1971 Jan-Feb;14(1):19–26. doi: 10.1002/art.1780140104. [DOI] [PubMed] [Google Scholar]
- Tingle A. J., Kettyls G. D., Ford D. K. Studies on vaccine-induced rubella arthritis. Serologic findings before and after immunization. Arthritis Rheum. 1979 Apr;22(4):400–402. doi: 10.1002/art.1780220414. [DOI] [PubMed] [Google Scholar]
- Weibel R. E., Stokes J., Jr, Buynak E. B., Hilleman M. R. Influence of age on clinical response to HPV-77 duck rubella vaccine. JAMA. 1972 Nov 13;222(7):805–807. [PubMed] [Google Scholar]