Despite the fact that intravenous typhoid vaccine has been used in the treatment of inflammatory diseases of the eye for over 30 years, its mode of action has remained obscure. Many theories have been advanced in an attempt to explain the dramatic benefit which clinicians have observed, in some cases, following typhoid vaccine treatment. However, the underlying mechanism of this treatment is still unknown.
In the past decade, as more information has accumulated concerning the physiology of the adrenal cortex, the assumption has grown among ophthalmologists that typhoid vaccine exerts its beneficial effects by activating the adrenal gland. It is postulated that the injection of typhoid vaccine provides a stressful stimulus and that the pituitary-adrenal axis responds with the release of endogenous adrenocorticosteroids. This assumption is supported by several experimental facts: Intravenous typhoid vaccine has been shown to cause depletion of cholesterol in the adrenal cortex of rats.1 In
DONN A. Effect of Intravenous Typhoid Vaccine on Plasma Adrenal Cortical Steriods. AMA Arch Ophthalmol. 1956;56(6):825-829. doi:10.1001/archopht.1956.00930040833003