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|Aluminium hydroxide is known to potently stimulate the immune system and to shift responses towards a Th-2 profile. It is possible that persistent systemic immune activation that fails to switch off constitutes the pathophysiological basis of the chronic fatigue syndrome associated with macrophagic myofasciitis and possibly in patients with post-infectious chronic fatigue and idiopathic chronic fatigue syndrome. Therefore, the WHO have recommended an epidemiological survey, currently conducted by the French agency AFSSAPS, aimed at substantiating a possible link between focal macrophagic myofasciitis (or previous immunization with aluminium-containing vaccines) and systemic symptoms.
Interestingly, a special emphasis has been put on Th-2 biased immune responses as a possible explanation of chronic fatigue and associated manifestations known as the Gulf War syndrome. Results from studies of MF may well open new avenues for the aetiological investigation of this syndrome. Indeed, both the type and structure of symptoms are strikingly similar between Gulf War veterans and patients with MF. Multiple vaccinations performed over a short period of time in the Persian Gulf area have been recognized as the main risk factor for the Gulf War syndrome. Moreover, the war vaccine against anthrax, given by a 6-shot regimen, seems to be critically involved and contains aluminum hydroxide as an adjuvant. Squalene is also present and may be another Th2 adjuvant. If safety concerns about the long-term effects of aluminium hydroxide are confirmed, it will be essential to develop novel, alternative adjuvants to re-establish confidence in vaccination and the huge benefits for public health that it provides worldwide.
“I want to sell drugs to everyone. I want to sell drugs to healthy people. I want drugs to sell like chewing gum.” former Merck CEO, Henry Gadsden
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