Diverse effects on vaccine-specific serum IgG titres and memory B cells upon methotrexate and anti-TNF-α therapy in children with rheumatic diseases: A cross-sectional study

Ingelman-Sundberg, Hanna M.; Laestadius, Åsa; Chrapkowska, Cecilia; Mördrup, Karina; Magnusson, Bo; Sundberg, Erik; Nilsson, Anna

doi:10.1016/j.vaccine.2016.01.027

Cited by 19 publications

(42 citation statements)

References 35 publications

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“…[30] We found that measles-specific IgGs from NSP patients present a significant lower avidity compared with those isolated from SP children. In contrast with recent data produced in children affected by rheumatic diseases under immunosuppressive therapy, [31] avidity data from this study suggest that Tps may present an overall impairment of the antibody functionality.…”

Section: Discussioncontrasting

confidence: 99%

“…Similarly, recent evidences reported reduced frequencies of MSMBC in children under treatment with immunomodulating agents such as methotrexate or anti-TNFα. [31] The lower frequency of MSMBC can be also partially explained by the underlying alterations reported into the B-cell compartment of these patients. Indeed, when being challenged by the chronic presence of a not-self antigen (the transplanted organ), the immune system is forced to be over-activated.…”

Section: Discussionmentioning

confidence: 99%

“…This finding suggests a higher negative impact of the immunosuppressive therapy when started before the MSMBC pool is fully established. [31] In addition, other immunological factors belonging to the T cell compartment directly affecting the establishment of long-term memory responses should be considered. In line with other authors, we previously showed in this cohort a progressive impairment of T-follicular Helper cells.…”

Section: Discussionmentioning

confidence: 99%

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Waning of vaccine-induced immunity to measles in kidney transplanted children

Rocca

Santilli²,

Cotugno

et al. 2016

Medicine

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Vaccine-preventable diseases are a significant cause of morbidity and mortality in solid organ transplant recipients who undergo immunosuppression after transplantation. Data on immune responses and long-term maintenance after vaccinations in such population are still limited.We cross-sectionally evaluated the maintenance of immune response to measles vaccine in kidney transplanted children on immunosuppressive therapy. Measles-specific enzyme-linked immunosorbent assay and B-cell enzyme-linked immunosorbent spot were performed in 74 kidney transplant patients (Tps) and in 23 healthy controls (HCs) previously vaccinated and tested for humoral protection against measles. The quality of measles antibody response was measured by avidity test. B-cell phenotype, investigated via flow cytometry, was further correlated to the ability of Tps to maintain protective humoral responses to measles over time.We observed the loss of vaccine-induced immunity against measles in 19% of Tps. Nonseroprotected children showed signs of impaired B-cell distribution as well as immune senescence and lower antibody avidity. We further reported as time elapsed between vaccination and transplantation, as well as the vaccine administration during dialysis are clinical factors affecting the maintenance of the immune memory response against measles.Tps present both quantitative and qualitative alterations in the maintenance of protective immunity to measles vaccine. Prospective studies are needed to optimize the vaccination schedules in kidney transplant recipients in order to increase the immunization coverage over time in this population.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Waning of vaccine-induced immunity to measles in kidney transplanted children

Rocca

Santilli²,

Cotugno

et al. 2016

Medicine

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“…In rheumatic disease, concomitant therapy with a biologic and methotrexate prevented the development of antibodies against the biologic (30). Available data on methotrexate's impact on B cells indicate that it does not impact the overall CD19% but rather impacts B cell subsets and immunoglobulin levels (56)(57)(58). Our tracking of B cell depletion is limited by inconsistent collection of absolute counts with consistent reporting of CD19%.…”

Section: Discussionmentioning

confidence: 99%

Benefits of Prophylactic Short-Course Immune Tolerance Induction in Patients With Infantile Pompe Disease: Demonstration of Long-Term Safety and Efficacy in an Expanded Cohort

et al. 2020

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Immune tolerance induction (ITI) with a short-course of rituximab, methotrexate, and/or IVIG in the enzyme replacement therapy (ERT)-naïve setting has prolonged survival and improved clinical outcomes in patients with infantile Pompe disease (IPD) lacking endogenous acid-alpha glucosidase (GAA), known as cross-reactive immunologic material (CRIM)-negative. In the context of cancer therapy, rituximab administration results in sustained B-cell depletion in 83% of patients for up to 26-39 weeks with B-cell reconstitution beginning at approximately 26 weeks post-treatment. The impact of rituximab on serum immunoglobulin levels is not well studied, available data suggest that rituximab can cause persistently low immunoglobulin levels and adversely impact vaccine responses. Data on a cohort of IPD patients who received a short-course of ITI with rituximab, methotrexate, and IVIG in the ERT-naïve setting and had ≥6 months of follow-up were retrospectively studied. B-cell quantitation, ANC, AST, ALT, immunization history, and vaccine titers after B-cell reconstitution were reviewed. Data were collected for 34 IPD patients (25 CRIM-negative and 9 CRIM-positive) with a median age at ERT initiation of 3.5 months (0.1-11.0 months). B-cell reconstitution, as measured by normalization of CD19%, was seen in all patients (n = 33) at a median time of 17 weeks range (11-55 weeks) post-rituximab. All maintained normal CD19% with the longest follow-up being 248 weeks post-rituximab. 30/34 (88%) maintained negative/low anti-rhGAA antibody titers, even with complete B-cell reconstitution. Infections during immunosuppression were reported in five CRIM-negative IPD patients, all resolved satisfactorily on antibiotics. There were no serious sequelae or deaths. Of the 31 evaluable patients, 27 were up to date on age-appropriate immunizations. Vaccine titers were available for 12 patients after B-cell reconstitution and adequate humoral response was observed in all except an Desai et al. Long-Term Safety of ITI in IPD Patients inadequate response to the Pneumococcal vaccine (n = 2). These data show the benefits of short-course prophylactic ITI in IPD both in terms of safety and efficacy. Data presented here are from the youngest cohort of patients treated with rituximab and expands the evidence of its safety in the pediatric population.

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“…Çocukluk çağında yapılan bir çalışmada romatizmal hastalığı olan ve DMARD tedavisi alan çocuklarda aşıya özgül hafıza B hücreleri korunmakta ancak serum antikor titreleri düşük olabileceği öne sürülmektedir. Bu çocuk hasta grubuna aşıların zamanında ve uygun dozda yapılabileceği ancak erişkin dönemde titre kontrolü bakılmasının önemini vurgulamışlardır (8). Biyolojik ajan kullanan annelerin bebeklerindeki aşı uygulamaları ve aşı etkinliği ile ilgili veriler net değildir.…”

unclassified

İnflamatuvar Bağırsak Hastalığı Nedeniyle Biyolojik Ajan Tedavisi Alan Kadınların Emzirdikleri Süt Çocuklarında İlaç Maruziyet Düzeyleri ve Emzirmenin Gelişim, Enfeksiyonlar Üzerine Etkisi

Törün¹

2018

J Pediatr Inf

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Diverse effects on vaccine-specific serum IgG titres and memory B cells upon methotrexate and anti-TNF-α therapy in children with rheumatic diseases: A cross-sectional study

Cited by 19 publications

References 35 publications

Waning of vaccine-induced immunity to measles in kidney transplanted children

Waning of vaccine-induced immunity to measles in kidney transplanted children

Benefits of Prophylactic Short-Course Immune Tolerance Induction in Patients With Infantile Pompe Disease: Demonstration of Long-Term Safety and Efficacy in an Expanded Cohort

İnflamatuvar Bağırsak Hastalığı Nedeniyle Biyolojik Ajan Tedavisi Alan Kadınların Emzirdikleri Süt Çocuklarında İlaç Maruziyet Düzeyleri ve Emzirmenin Gelişim, Enfeksiyonlar Üzerine Etkisi

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