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Heat, oxidation and exposure to aldehydes create reactive carbonyl groups on proteins, targeting antigens to scavenger receptors. Formaldehyde is widely used in making vaccines, but has been associated with atypical enhanced disease during subsequent infection with paramyxoviruses. We show that carbonyl groups on formaldehyde-treated vaccine antigens boost T helper type 2 (T(H)2) responses and enhance respiratory syncytial virus (RSV) disease in mice, an effect partially reversible by chemical reduction of carbonyl groups.

Original publication




Journal article


Nat Med

Publication Date





905 - 907


Animals, Antigens, Viral, Bronchoalveolar Lavage Fluid, Eosinophilia, Formaldehyde, Immunization, Interferon-gamma, Interleukin-5, Lung, Mice, Mice, Inbred BALB C, Neutralization Tests, Ovalbumin, Respiratory Hypersensitivity, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus Vaccines, Respiratory Syncytial Viruses, Th2 Cells, Time Factors, Vaccines, Inactivated