{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T12:38:37Z","timestamp":1777293517785,"version":"3.51.4"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T00:00:00Z","timestamp":1675814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["Grant\u2010in\u2010Aid for Scientific Research KAKENHI (B):"],"award-info":[{"award-number":["Grant\u2010in\u2010Aid for Scientific Research KAKENHI (B):"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["KAKENHI Grant\u2010in\u2010Aid for Scientific Research (C):"],"award-info":[{"award-number":["KAKENHI Grant\u2010in\u2010Aid for Scientific Research (C):"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["COBRE Grant \/ P30\u2010GM110703"],"award-info":[{"award-number":["COBRE Grant \/ P30\u2010GM110703"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cervical cancer is caused by human papillomavirus (HPV) infection, which is preventable by HPV vaccines. In Japan, the HPV vaccination rate has remained extremely low due to the concerns for alleged neuropsychological symptoms or \u201cdiverse symptoms\u201d following injections of two HPV vaccines, Cervarix and Gardasil, in HPV vaccine lawsuits. In the lawsuits, the attorneys' group has used several manuscripts proposing that aluminum (Al) adjuvant contained in HPV vaccines causes an immune\u2010mediated disease, called macrophagic myofasciitis (MMF), as well as pathology in the central nervous system (CNS). We scientifically evaluated these manuscripts describing the \u201cAl adjuvant\u2013induced pathologies,\u201d particularly MMF. Although MMF patients have been reported to develop clinical symptoms\/signs in various organs, including the CNS, muscle biopsy of the patients and animal experiments demonstrated that MMF pathology was localized only at the injected muscle. No muscle pathology which characterizes MMF was observed in any other muscles; thus, the systemic and neurological signs of MMF cases were irrelevant to localized MMF pathology. We evaluated that MMF\u2010like pathology was induced as a local inflammatory response following vaccinations; MMF pathology was not the cause of systemic inflammation or \u201cdiverse symptoms.\u201d Lastly, MMF cases have been reported after vaccinations with Al\u2010hydroxide\u2013containing vaccines exclusively. As Al\u2010hydroxide is a component of Cervarix, but not Gardasil, \u201cdiverse symptoms\u201d following two HPV vaccinations in Japan cannot be explained by MMF. Our evaluation would help readers understand the validity of the manuscripts on the role of Al adjuvants or MMF for the alleged \u201cdiverse symptoms.\u201d<\/jats:p>","DOI":"10.1111\/cas.15714","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T09:05:19Z","timestamp":1672909519000},"page":"1218-1228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Critical evaluation on roles of macrophagic myofasciitis and aluminum adjuvants in <scp>HPV<\/scp> vaccine\u2013induced adverse events"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4512-7975","authenticated-orcid":false,"given":"Noriomi","family":"Matsumura","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reona","family":"Shiro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1798-714X","authenticated-orcid":false,"given":"Ikuo","family":"Tsunoda","sequence":"additional","affiliation":[{"name":"Department of Microbiology Kindai University Faculty of Medicine  Osaka 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