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Vaccine–Drug Interactions: Cytokines, Cytochromes, and Molecular Mechanisms

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Abstract

Vaccinations are recommended throughout life to reduce the risk of vaccine-preventable diseases and their sequelae. Vaccines are often administered in patients with chronic diseases who are likely to be treated with several drugs. A growing number of clinical observations have indicated the possibility of interactions between vaccines and drugs, leading to changes in drug metabolism after vaccination. These interactions represent a significant concern because of the increasing use of vaccines in older patients who are likely to be treated with several drugs. Because of the possible implications of adverse reactions in terms of public health, several studies were performed to verify the risk posed by these interactions and to clarify the biologic mechanisms that drive these events. Of the several mechanisms proposed to be at the basis of vaccine–drug interactions, the most convincing evidence suggests a role of inflammatory cytokines on the regulation of specific cytochrome P450 enzymes in the liver. Differences in the cytochrome P450 enzymes involved in the metabolism of these drugs could explain these contrasting results and provide important insights to fully understand the clinical importance of these events. Further studies are required to verify whether vaccine–drug interactions may occur in other clinical settings, especially the ones for which patients are required to be vaccinated against specific diseases.

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Authors and Affiliations

  1. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital “Luigi Sacco”, University of Milan, Via GB Grassi 74, 20157, Milan, Italy

    Paolo Pellegrino, Cristiana Perrotta & Sonia Radice

  2. Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842, Lecco, Italy

    Emilio Clementi

  3. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Consiglio Nazionale delle Ricerche Institute of Neuroscience, University Hospital “Luigi Sacco”, University of Milan, 20157, Milan, Italy

    Emilio Clementi

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  1. Paolo Pellegrino
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  2. Cristiana Perrotta
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  3. Emilio Clementi
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  4. Sonia Radice
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Correspondence to Paolo Pellegrino.

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This work was supported by grants from the Italian Medicines Agency (Agenzia Italiana del Farmaco) and the Ministry of Health (Ricerca Corrente 2015) to EC.

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Paolo Pellegrino, Cristiana Perrotta, Emilio Clementi and Sonia Radice have no conflicts of interest that are directly relevant to the content of this study.

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Pellegrino, P., Perrotta, C., Clementi, E. et al. Vaccine–Drug Interactions: Cytokines, Cytochromes, and Molecular Mechanisms. Drug Saf 38, 781–787 (2015). https://doi.org/10.1007/s40264-015-0330-8

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