{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:12:39Z","timestamp":1788930759118,"version":"build-2803163510"},"reference-count":24,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:00:00Z","timestamp":1262304000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Yellow fever (YF) vaccines (17D-204 and 17DD) are well tolerated and cause very low rates of severe adverse events (YEL-SAE), such as serious allergic reactions, neurotropic adverse diseases (YEL-AND), and viscerotropic diseases (YEL-AVD). Viral and host factors have been postulated to explain the basis of YEL-SAE. However, the mechanisms underlying the occurrence of YEL-SAE remain unknown. The present report provides a detailed immunological analysis of a 23-year-old female patient. The patient developed a suspected case of severe YEL-AVD with encephalitis, as well as with pancreatitis and myositis, following receipt of a 17D-204 YF vaccination. The patient exhibited a decreased level of expression of Fc-\u03b3R in monocytes (CD16, CD32, and CD64), along with increased levels of NK T cells (an increased CD3\n            <jats:sup>+<\/jats:sup>\n            CD16\n            <jats:sup>+\/\u2212<\/jats:sup>\n            CD56\n            <jats:sup>+\/\u2212<\/jats:sup>\n            \/CD3\n            <jats:sup>+<\/jats:sup>\n            ratio), activated T cells (CD4\n            <jats:sup>+<\/jats:sup>\n            and CD8\n            <jats:sup>+<\/jats:sup>\n            cells), and B lymphocytes. Enhanced levels of plasmatic cytokines (interleukin-6 [IL-6], IL-17, IL-4, IL-5, and IL-10) as well as an exacerbated\n            <jats:italic>ex vivo<\/jats:italic>\n            intracytoplasmic cytokine pattern, mainly observed within NK cells (gamma interferon positive [IFN-\u03b3\n            <jats:sup>+<\/jats:sup>\n            ], tumor necrosis factor alpha positive [TNF-\u03b1\n            <jats:sup>+<\/jats:sup>\n            ], and IL-4 positive [IL-4\n            <jats:sup>+<\/jats:sup>\n            ]), CD8\n            <jats:sup>+<\/jats:sup>\n            T cells (IL-4\n            <jats:sup>+<\/jats:sup>\n            and IL-5\n            <jats:sup>+<\/jats:sup>\n            ), and B lymphocytes (TNF-\u03b1\n            <jats:sup>+<\/jats:sup>\n            , IL-4\n            <jats:sup>+<\/jats:sup>\n            , and IL-10\n            <jats:sup>+<\/jats:sup>\n            ). The analysis of CD4\n            <jats:sup>+<\/jats:sup>\n            T cells revealed a complex profile that consisted of an increased frequency of IL-12\n            <jats:sup>+<\/jats:sup>\n            and IFN-\u03b3\n            <jats:sup>+<\/jats:sup>\n            cells and a decreased percentage of TNF-\u03b1\n            <jats:sup>+<\/jats:sup>\n            , IL-4\n            <jats:sup>+<\/jats:sup>\n            , and IL-5\n            <jats:sup>+<\/jats:sup>\n            cells. Depressed cytokine synthesis was observed in monocytes (TNF-\u03b1\n            <jats:sup>+<\/jats:sup>\n            ) following the provision of antigenic stimuli\n            <jats:italic>in vitro<\/jats:italic>\n            . These results support the hypothesis that a strong adaptive response and abnormalities in the innate immune system may be involved in the establishment of YEL-AND and YEL-AVD.\n          <\/jats:p>","DOI":"10.1128\/cvi.00369-09","type":"journal-article","created":{"date-parts":[[2009,11,12]],"date-time":"2009-11-12T03:17:06Z","timestamp":1257995826000},"page":"118-126","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":49,"title":["Clinical and Immunological Insights on Severe, Adverse Neurotropic and Viscerotropic Disease following 17D Yellow Fever Vaccination"],"prefix":"10.1128","volume":"17","author":[{"given":"Maria Luiza","family":"Silva","sequence":"first","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u0327andra Ramos","family":"Espi\u0301rito-Santo","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"},{"name":"Universidade Estadual de Montes Claros, Campus Universita\u0301rio Darcy Ribeiro, Vila Maurice\u0301ia, Montes Claros, MG CEP 39401-089, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Angela","family":"Martins","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Silveira-Lemos","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"},{"name":"Nu\u0301cleo de Po\u0301s-graduac\u0327a\u0303o em Cie\u0302ncias Biolo\u0301gicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, MG CEP 35400-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Peruhype-Magalha\u0303es","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Pesquisa Cli\u0301nicas, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Carvalho","family":"Caminha","sequence":"additional","affiliation":[{"name":"Hospital Universita\u0301rio, Universidade Federal do Rio de Janeiro, Avenida Trompowski s\/n, 9\u00b0 Andar, Ilha do Funda\u0303o, Rio de Janeiro, RJ, CEP 21941-590, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pe\u0301ricles","family":"de Andrade Maranha\u0303o-Filho","sequence":"additional","affiliation":[{"name":"Hospital Universita\u0301rio, Universidade Federal do Rio de Janeiro, Avenida Trompowski s\/n, 9\u00b0 Andar, Ilha do Funda\u0303o, Rio de Janeiro, RJ, CEP 21941-590, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Auxiliadora-Martins","sequence":"additional","affiliation":[{"name":"Hospital das Cli\u0301nicas-HC, Faculdade de Medicina de Ribeira\u0303o Preto-FMRP, Universidade de Sa\u0303o Paulo-USP, Av. dos Bandeirantes 3900, Ribeira\u0303o Preto, SP CEP 14048-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinaldo","family":"de Menezes Martins","sequence":"additional","affiliation":[{"name":"Instituto de Tecnologia em Imunobiolo\u0301gicos-Biomanguinhos, FIOCRUZ\/Rio, Av. 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Brasil n\u00b0 4365, Manguinhos, Rio de Janeiro, RJ CEP 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk E.","family":"Teuwen","sequence":"additional","affiliation":[{"name":"Rega Institute, Catholic University of Leuven, Oude Markt 13, Leuven 5005 3000, Belgium"},{"name":"International Laboratory Network for Yellow Fever Vaccine Associated Adverse Events, Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, Texas 77555-0609"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana Maria","family":"Elo\u0301i-Santos","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"},{"name":"Departamento de Propede\u0302utica Cli\u0301nica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Alfredo Balena n\u00b0 190, Santa Efige\u0302nia, Belo Horizonte, MG CEP 30130-100, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marile\u0301ia Chaves","family":"Andrade","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"},{"name":"Universidade Estadual de Montes Claros, Campus Universita\u0301rio Darcy Ribeiro, Vila Maurice\u0301ia, Montes Claros, MG CEP 39401-089, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre\u0301a","family":"Teixeira-Carvalho","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olindo Assis","family":"Martins-Filho","sequence":"additional","affiliation":[{"name":"Laborato\u0301rio de Biomarcadores de Diagno\u0301stico e Monitorac\u0327a\u0303o, Centro de Pesquisas Rene\u0301 Rachou, FIOCRUZ\/Minas, Avenida Augusto de Lima 1715, Barro Preto, Belo Horizonte, MG CEP 30190-002, Brazil"},{"name":"International Laboratory Network for Yellow Fever Vaccine Associated Adverse Events, Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, Texas 77555-0609"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1086\/587844","volume":"197","year":"2008","unstructured":"Bae, H. 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