Less Macrophage Inflammatory Protein 3alpha and β-defensin Found in Individuals with Atopic Dermatitis and Why It Matters Concerning the Vaccinia Virus

Atopic Dermatitis (AD), commonly known as eczema causes rashes on skin. The smallpox vaccine is made from the vaccinia virus (VV) which is a poxvirus closely related to smallpox but less harmful. The Smallpox vaccine has live vaccinia virus that isn’t in a weaker form like many other vaccines.  Those with AD are more likely to develop eczema vaccinatum which occurs when VV is implanted into a person’s skin though the smallpox vaccination. The VV spreads to cells causing lesions, outbreaks can occur on other parts of the skin other than the initial infected area.  

Those with AD are likely to have an allergic reaction to something coming into contact with the skin like environmental allergens or a vaccination that the immune system tries to attack causing the same outbreak that was trying to be prevented in the first place by receiving the vaccination. An individual without AD will create antibodies after receiving the smallpox vaccination that will prevent a smallpox infection if that person ever comes into contact with the smallpox virus whereas an individual with AD will have an allergic reaction to the smallpox vaccination causing rashes that have an appearance just like smallpox. This is why the Centers for Disease Control and Prevention doesn’t require individuals with AD to receive the smallpox vaccination. 

 

The results of one study suggest that Macrophage inflammatory protein 3alpha is critical in the immune response against VV. Someone with AD lacks a sufficient amount of MIP-3alpha. Increasing MIP-3alpha could help prevent severe reactions for those with AD if they receive the smallpox vaccination (Kim et al., 2007).  Another study showed that, “deficiency in HBD-3 increases the susceptibility of patients with AD to systemic VV infection after smallpox vaccination” (Howell et al., 2007).  HBD-3 is a 45 amino acid antimicrobial peptide. 

 

Although rare, there have been reported cases of a smallpox vaccinee, infecting an individual with AD though close contact. If smallpox vaccines were used again would enough screening be done to make sure those with AD do not receive the vaccine and do not come into contact with someone who has recently been vaccinated with the smallpox vaccine? Could individuals with AD increase the amount of MIP-3alpha or HBD-3 in their skin so they could still receive the smallpox vaccine? It would be a win, win situation if an individual with AD could receive the VV vaccine so they are protected against smallpox but without the vaccine creating an outbreak. Smallpox and Eczema Vaccinatum can be fatal therefore learning the role MIP-3alpha and HBD-3 play in preventing an outbreak is huge to further understand AD and possibly improve the lives of those with AD. 

 

References

Centers for Disease Control and Prevention. (2017, July 12). Vaccine basics. Centers for Disease Control and Prevention. Retrieved October 8, 2021, from https://www.cdc.gov/smallpox/vaccine-basics/index.html. 

Howell, M. D., Streib, J. E., & Leung, D. Y. (2007). Antiviral activity of human beta-defensin 3       

against vaccinia virus. The Journal of allergy and clinical immunology, 119(4), 1022–1025. https://doi.org/10.1016/j.jaci.2007.01.044

 

Jennifer L. Reed, Dorothy E. Scott, Mike Bray, Eczema Vaccinatum, Clinical Infectious 

        Diseases, Volume 54, Issue 6, 15 March 2012, Pages 832–840, 

        https://doi.org/10.1093/cid/cir952

 

Kim, B. E., Leung, D. Y., Streib, J. E., Kisich, K., Boguniewicz, M., Hamid, Q. A., & Howell, M. 

        D. (2007). Macrophage inflammatory protein 3alpha deficiency in atopic dermatitis skin 

        and role in innate immune response to vaccinia virus. The Journal of allergy and clinical 

        immunology, 119(2), 457–463. https://doi.org/10.1016/j.jaci.2006.10.005