Silva, Maria Luiza
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Espirito-Santo, Lucandra Ramos
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Martins, Marina Angela
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Silveira-Lemos, Denise
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Peruhype-Magalhaes, Vanessa
[FIOCRUZ Minas, Lab Pesquisa Clin, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Caminha, Ricardo Carvalho
[Univ Fed Rio de Janeiro, Univ Hosp, BR-21941590 Rio De Janeiro, Brazil]
Maranhao-Filho, Pericles de Andrade
[Univ Sao Paulo, Hosp Clin, Fac Med Ribeirao Preto, BR-14048900 Ribeirao Preto, SP Brazil]
Auxiliadora-Martins, Maria
[Univ Sao Paulo, Hosp Clin, Fac Med Ribeirao Preto, BR-14048900 Ribeirao Preto, SP Brazil]
Martins, Reinaldo de Menezes
[FIOCRUZ Rio, Inst Tecnol Imunobiol Biomanguinhos, BR-21040360 Rio De Janeiro, Brazil]
Galler, Ricardo
[FIOCRUZ Rio, Inst Tecnol Imunobiol Biomanguinhos, BR-21040360 Rio De Janeiro, Brazil]
Freire, Marcos da Silva
[FIOCRUZ Rio, Inst Tecnol Imunobiol Biomanguinhos, BR-21040360 Rio De Janeiro, Brazil]
Marcovistz, Rugimar
[FIOCRUZ Rio, Inst Tecnol Imunobiol Biomanguinhos, BR-21040360 Rio De Janeiro, Brazil]
Homma, Akira
[FIOCRUZ Rio, Inst Tecnol Imunobiol Biomanguinhos, BR-21040360 Rio De Janeiro, Brazil]
Teuwen, Dirk E.
[UCL]
Eloi-Santos, Silvana Maria
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Andrade, Marileia Chaves
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Teixeira-Carvalho, Andrea
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Martins-Filho, Olindo Assis
[FIOCRUZ Minas, Lab Biomarcadores Diagnost & Monitoracao, Ctr Pesquisas Rene Rachou, BR-30190002 Belo Horizonte, MG Brazil]
Yellow fever (YF) vaccines (17D-204 and 17DD) are well tolerated and cause very low rates of severe adverse events (YEL-SAE), such as serious allergic reactions, neurotropic adverse diseases (YEL-AND), and viscerotropic diseases (YEL-AVD). Viral and host factors have been postulated to explain the basis of YEL-SAE. However, the mechanisms underlying the occurrence of YEL-SAE remain unknown. The present report provides a detailed immunological analysis of a 23-year-old female patient. The patient developed a suspected case of severe YEL-AVD with encephalitis, as well as with pancreatitis and myositis, following receipt of a 17D-204 YF vaccination. The patient exhibited a decreased level of expression of Fc-gamma R in monocytes (CD16, CD32, and CD64), along with increased levels of NK T cells (an increased CD3(+) CD16(+/-) CD56(+/-)/CD3(+) ratio), activated T cells (CD4(+) and CD8(+) cells), and B lymphocytes. Enhanced levels of plasmatic cytokines (interleukin-6 [IL-6], IL-17, IL-4, IL-5, and IL-10) as well as an exacerbated ex vivo intracytoplasmic cytokine pattern, mainly observed within NK cells (gamma interferon positive [IFN-gamma(+)], tumor necrosis factor alpha positive [TNF-alpha(+)], and IL-4 positive [IL-4(+)]), CD8(+) T cells (IL-4(+) and IL-5(+)), and B lymphocytes (TNF-alpha(+), IL-4(+), and IL-10(+)). The analysis of CD4(+) T cells revealed a complex profile that consisted of an increased frequency of IL-12(+) and IFN-gamma(+) cells and a decreased percentage of TNF-alpha(+), IL-4(+), and IL-5+ cells. Depressed cytokine synthesis was observed in monocytes (TNF-alpha(+)) following the provision of antigenic stimuli in vitro. These results support the hypothesis that a strong adaptive response and abnormalities in the innate immune system may be involved in the establishment of YEL-AND and YEL-AVD.