Allergenic components of the mRNA‐1273 vaccine for COVID‐19: Possible involvement of polyethylene glycol and IgG‐mediated complement activation

Allergy: European Journal of Allergy and Clinical Immunology - Tập 76 Số 11 - Trang 3307-3313 - 2021
Ludger Klimek1, Natalija Novak2, Beatriz Cabanillas3, Marek Jutel4, Jean Bousquet5,6,7, Cezmi A. Akdiş8
1Center for Rhinology and Allergology, Wiesbaden, Germany
2Department of Dermatology and Allergy University Hospital Bonn Germany
3Department of Allergy Research Institute Hospital 12 de Octubre Madrid Spain
4Department of Clinical Immunology Wrocław Medical University, Poland ALL‐MED Medical research Institute Wroclaw Poland
5Comprehensive Allergy Center Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin Berlin Institute of Health Berlin Germany
6Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon
7MACVIA France, Montpellier, France
8Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland

Tóm tắt

AbstractFollowing the emergency use authorization of the mRNA‐1273 vaccine on the 18th of December 2020, two mRNA vaccines are in current use for the prevention of coronavirus disease 2019 (COVID‐19). For both mRNA vaccines, the phase III pivotal trials excluded individuals with a history of allergy to vaccine components. Immediately after the initiation of vaccination in the United Kingdom, Canada, and the United States, anaphylactic reactions were reported. While the culprit trigger requires investigation, initial reports suggested the excipient polyethylene glycol 2000 (PEG‐2000)—contained in both vaccines as the PEG‐micellar carrier system—as the potential culprit. Surface PEG chains form a hydrate shell to increase stability and prevent opsonization. Allergic reactions to such PEGylated lipids can be IgE‐mediated, but may also result from complement activation‐related pseudoallergy (CARPA) that has been described in similar liposomes. In addition, mRNA‐1273 also contains tromethamine (trometamol), which has been reported to cause anaphylaxis to substances such as gadolinium‐based contrast media. Skin prick, intradermal and epicutaneous tests, in vitro sIgE assessment, evaluation of sIgG/IgM, and basophil activation tests are being used to demonstrate allergic reactions to various components of the vaccines.

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Allergy: European Journal of Allergy and Clinical Immunology

Tập 76 Số 11

3307-3313

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