Prospective surveillance study of acute respiratory infections, influenza-like illness and seasonal influenza vaccine in a cohort of juvenile idiopathic arthritis patients

Carvalho, Luciana; Paula, Flávia Escremim de; Silvestre, Rodrigo Vellasco Duarte; Roberti, L; Arruda, Eurico; Mello, Wyller Alencar de; Ferriani, Virgínia P.

doi:10.1186/1546-0096-11-10

Cited by 21 publications

(40 citation statements)

References 32 publications

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“…Multiple studies 44,57,58 have correlated elevations in the proinflammatory cytokine IL-6 with the severity of symptoms in pediatric patients, and the IL-6 antagonist tociluzimab was incidentally seen to decrease the duration of symptoms during IAV infection. 59 Increased IL-6 was associated with more severe lung injury and death in a ferret model of IAV infection. 60 However, complete absence of IL-6 may be harmful, with IL-6 knockout mice having increased viral titers and less likelihood of survival following IAV infection.…”

Section: Age-dependent Differences In Susceptibility To Iavmentioning

confidence: 93%

Influenza A Virus Infection, Innate Immunity, and Childhood

et al. 2015

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Infection with influenza A virus is responsible for considerable morbidity and mortality in children worldwide. While it is apparent that adequate activation of the innate immune system is essential for pathogen clearance and host survival, an excessive inflammatory response to infection is detrimental to the young host. A review of the literature indicates that innate immune responses change throughout childhood. Whether these changes are genetically programmed or triggered by environmental cues is unknown. The objectives of this review are to summarize the role of innate immunity in influenza A virus infection in the young child and to highlight possible differences between children and adults that may make children more susceptible to severe influenza A infection. A better understanding of age-related differences in innate immune signaling will be essential to improve care for this high-risk population.Influenza A virus (IAV) is a highly contagious RNA virus that causes respiratory tract infections in humans and animals. Seasonal IAV is responsible for considerable disease worldwide, with the World Health Organization estimating 3 to 5 million severe cases of IAV each year and approximately 250 000 to 500 000 deaths. 1 Pandemics threaten to affect significantly more people. During the 1918 pandemic, it is estimated that IAV was responsible for 50 to 100 million deaths. 2 The burden of IAV infection is highest in children, the elderly, and persons with chronic medical conditions. Each year, IAV infection affects up to 40% of children younger than 5 years in the United States and 90 million

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Section: Age-dependent Differences In Susceptibility To Iavmentioning

confidence: 93%

Influenza A Virus Infection, Innate Immunity, and Childhood

et al. 2015

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“…Of note, and relevant to the COVID-19 epidemic, in the aforementioned studies the respiratory system was usually the preferred site of infections. With regard specifically to viral infections, influenza has been quite extensively studied, also for the possibility of seasonal vaccination [42]. Among others, the incidence of Herpes Zoster Virus infections has been found to be almost three-fold higher in JIA patients [43].…”

Section: Juvenile Idiopathic Arthritis and Risk Of Infectionsmentioning

confidence: 99%

COVID-19 and what pediatric rheumatologists should know: a review from a highly affected country

et al. 2020

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On March 11th, 2020 the World Health Organization declared COVID-19 a global pandemic. The infection, transmitted by 2019 novel coronavirus (2019-nCov), was first discovered in December 2019, in Wuhan, Hubei Province, and then rapidly spread worldwide. Italy was early and severely involved, with a critical spread of the infection and a very high number of victims. Person-to-person spread mainly occurs via respiratory droplets and contact. The median incubation period is 5 days. The spectrum of respiratory symptoms may range from mild to severe, strictly depending on the age of the patient and the underlying comorbidities. In children COVID-19 related disease is less frequent and less aggressive. In Italy 1% of positive cases are under 18 years of age, and no deaths have been recorded before 29 years of age. For patients affected by rheumatic disease, despite the concerns related to the imbalance of their immune response and the effect of immunosuppressive treatments, there are still few data to understand the real consequences of this infection. Major scientific societies have issued recommendations to help rheumatologists in caring their patients. Interestingly, some of the drugs mostly used by rheumatologists appear to be promising in critical COVID-19 infected patients, where the hyperinflammation and cytokine storm seem to drive to the multiorgan failure. Pediatric rheumatologists are expected to play a supporting role in this new front of COVID-19 pandemic, both as general pediatricians treating infected children, and as rheumatologists taking care of their rheumatic patients, as well as offering their experience in the possible alternative use of immunomodulatory drugs.

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“…Another five studies evaluated antibody persistence several years after vaccination [ 18 – 22 ]. Although some studies studied actual occurrence of infections such as herpes zoster (HZ) or influenza, they were underpowered to assess these outcomes reliably [ 13 ••, 23 , 24 ].…”

Section: Vaccine Immunogenicity In Paediatric Patients With Rheumaticmentioning

confidence: 99%

“… – Aikawa et al [ 36 ] a 16 anti-TNFα 63 DMARD/IS (prednisone, leflunomide, CYC, SSZ) 47 MTX 5–50 mg/week Versus 91 HC Influenza IG: 2b DAS: 3 Seroconverted patients (83.2 %) and non-seroconverted patients (16.8 %) had similar types and doses of therapy. – Carvalho et al [ 23 ] 31 MTX or leflunomide 6 GC dose 0.05–1 mg/kg/day 5 anti-TNFα 1 CSP Versus 10 HC Influenza 3 Anti-TNFα users had lower seroconversion and seroprotection rates to the H1N1 strain (60 versus 100 % in HC). 80 % of patients were seroprotected against the H2N3 and B strains, compared to 80 % and 100 % of HC, respectively.…”

Section: Vaccine Immunogenicity In Paediatric Patients With Rheumaticmentioning

confidence: 99%

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Vaccinations in Paediatric Rheumatology: an Update on Current Developments

2015

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In 2011, the European League Against Rheumatism (EULAR) published recommendations regarding the vaccination of children with rheumatic diseases. These recommendations were based on a systematic literature review published in that same year. Since then, the evidence body on this topic has grown substantially. This review provides an update of the systematic literature study of 2011, summarizing all the available evidence on the safety and immunogenicity of vaccination in paediatric patients with rheumatic diseases. The current search yielded 21 articles, in addition to the 27 articles described in the 2011 review. In general, vaccines are immunogenic and safe in this patient population. The effect of immunosuppressive drugs on the immunogenicity of vaccines was not detrimental for glucocorticosteroids and methotrexate. Biologicals could accelerate a waning of antibody levels over time, although most patients were initially protected adequately. Overall, persistence of immunological memory may be reduced in children with rheumatic diseases, which shows the need for (booster) vaccination. This update of the 2011 systematic literature review strengthens the evidence base for the EULAR recommendations, and it must be concluded that vaccinations in patients with rheumatic diseases should be advocated.

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Prospective surveillance study of acute respiratory infections, influenza-like illness and seasonal influenza vaccine in a cohort of juvenile idiopathic arthritis patients

Cited by 21 publications

References 32 publications

Influenza A Virus Infection, Innate Immunity, and Childhood

Influenza A Virus Infection, Innate Immunity, and Childhood

COVID-19 and what pediatric rheumatologists should know: a review from a highly affected country

Vaccinations in Paediatric Rheumatology: an Update on Current Developments

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