Original antigenic sin: A comprehensive review. 2017

Anup Vatti, and Diana M Monsalve, and Yovana Pacheco, and Christopher Chang, and Juan-Manuel Anaya, and M Eric Gershwin
University of California at Davis, Division of Rheumatology, Allergy and Clinical Immunology, Suite 6501, 451 Health Sciences Drive, Davis, CA, 95616, USA.

The concept of "original antigenic sin" was first proposed by Thomas Francis, Jr. in 1960. This phenomenon has the potential to rewrite what we understand about how the immune system responds to infections and its mechanistic implications on how vaccines should be designed. Antigenic sin has been demonstrated to occur in several infectious diseases in both animals and humans, including human influenza infection and dengue fever. The basis of "original antigenic sin" requires immunological memory, and our immune system ability to autocorrect. In the context of viral infections, it is expected that if we are exposed to a native strain of a pathogen, we should be able to mount a secondary immune response on subsequent exposure to the same pathogen. "Original antigenic sin" will not contradict this well-established immunological process, as long as the subsequent infectious antigen is identical to the original one. But "original antigenic sin" implies that when the epitope varies slightly, then the immune system relies on memory of the earlier infection, rather than mount another primary or secondary response to the new epitope which would allow faster and stronger responses. The result is that the immunological response may be inadequate against the new strain, because the immune system does not adapt and instead relies on its memory to mount a response. In the case of vaccines, if we only immunize to a single strain or epitope, and if that strain/epitope changes over time, then the immune system is unable to mount an accurate secondary response. In addition, depending of the first viral exposure the secondary immune response can result in an antibody-dependent enhancement of the disease or at the opposite, it could induce anergy. Both of them triggering loss of pathogen control and inducing aberrant clinical consequences.

UI MeSH Term Description Entries
D007108 Immune Tolerance The specific failure of a normally responsive individual to make an immune response to a known antigen. It results from previous contact with the antigen by an immunologically immature individual (fetus or neonate) or by an adult exposed to extreme high-dose or low-dose antigen, or by exposure to radiation, antimetabolites, antilymphocytic serum, etc. Immunosuppression (Physiology),Immunosuppressions (Physiology),Tolerance, Immune
D007156 Immunologic Memory The altered state of immunologic responsiveness resulting from initial contact with antigen, which enables the individual to produce antibodies more rapidly and in greater quantity in response to secondary antigenic stimulus. Immune Memory,Immunological Memory,Memory, Immunologic,Immune Memories,Immunologic Memories,Immunological Memories,Memory, Immune,Memory, Immunological
D007239 Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Infection,Infection and Infestation,Infections and Infestations,Infestation and Infection,Infestations and Infections
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000941 Antigens Substances that are recognized by the immune system and induce an immune reaction. Antigen
D014612 Vaccines Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa), antigenic proteins, synthetic constructs, or other bio-molecular derivatives, administered for the prevention, amelioration, or treatment of infectious and other diseases. Vaccine
D016056 Immunodominant Epitopes Subunits of the antigenic determinant that are most easily recognized by the immune system and thus most influence the specificity of the induced antibody. Antigenic Determinants, Immunodominant,Antigens, Immunodominant,Epitopes, Immunodominant,Immunodominant Determinant,Immunodominant Domain,Immunodominant Epitope,Immunodominant Region,Immunodominant Site,Immunodominant Determinants,Immunodominant Domains,Immunodominant Regions,Immunodominant Sites,Determinant, Immunodominant,Determinants, Immunodominant,Determinants, Immunodominant Antigenic,Domain, Immunodominant,Domains, Immunodominant,Epitope, Immunodominant,Immunodominant Antigenic Determinants,Immunodominant Antigens,Region, Immunodominant,Regions, Immunodominant,Site, Immunodominant,Sites, Immunodominant
D056724 Immunity, Humoral Antibody-mediated immune response. Humoral immunity is brought about by ANTIBODY FORMATION, resulting from TH2 CELLS activating B-LYMPHOCYTES, followed by COMPLEMENT ACTIVATION. Humoral Immune Response,Humoral Immune Responses,Humoral Immunity,Immune Response, Humoral,Immune Responses, Humoral,Response, Humoral Immune
D018448 Models, Immunological Theoretical representations that simulate the behavior or activity of immune system, processes, or phenomena. They include the use of mathematical equations, computers, and other electrical equipment. Immunological Models,Immunologic Model,Model, Immunologic,Immunologic Models,Immunological Model,Model, Immunological,Models, Immunologic

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