Correspondence
DNA Vaccines
N Engl J Med 1999; 341:1623-1624November 18, 1999
- Article
To the Editor:
Indeed, vaccines are among the triumphs of medical science. However, the enthusiasm of Seder and Gurunathan (July 22 issue)1 must be tempered with prudent restraint. They understate the potential harm to the patient evoked by “a strong cellular immune response not only against the microbial antigen but also against the host's own antigens.” Producing immunity by genetically engineered vaccines should not involve a risk of producing disease by immunostimulatory nucleotide sequences contained in plasmid vectors.
1 ReferencesPeter C. Freis, M.D.
Robert Wood Johnson University Hospital, New Brunswick, NJ 089011
Seder RA ,Gurunathan S . DNA vaccines -- designer vaccines for the 21st century. N Engl J Med 1999;341:277-278
Full Text | Web of Science | Medline
Author/Editor Response
The authors reply:
To the Editor: We appreciate the thoughtful comments of Dr. Freis regarding the potential danger of inducing an autoimmune disease after inducing a cellular immune response by DNA vaccination. Indeed, in our concluding paragraph we wrote, “We must also keep in mind that DNA vaccines could provoke a strong cellular immune response not only against the microbial antigen but also against the host's own antigens, thereby causing more harm than good.” We believe that this warning clearly and unequivocally states the potential dangers of inducing a strong cellular immune response by DNA vaccination.
Autoimmune diseases can be devastating, but the clinical course of disease in patients with malaria, tuberculo-sis, or human immunodeficiency virus infection is equally if not more devastating. Because of the enormity of the morbidity and mortality caused by these diseases, the benefits of successful DNA vaccines against them would have to be carefully weighed against the potential dangers. The potential risks, however, should not impede the careful use in scientific and clinical studies of DNA vaccines against diseases for which current vaccines have not been successful.
Finally, although it is still early, clinical studies in which DNA vaccines are used in humans have not shown any deleterious side effects.
Robert A. Seder, M.D.
Sanjay Gurunathan, M.D.
National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892
