TY - JOUR
T1 - The Effect of Maternal Peripartum Anti-TNFα Use on Infant Immune Response
AU - Sheibani, Sarah
AU - Cohen, Russell
AU - Kane, Sunanda
AU - Dubinsky, Marla
AU - Church, Joseph A.
AU - Mahadevan, Uma
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background: Infliximab (IFX) and adalimumab (ADA) cross the placenta in the third trimester and can be detectable in infants for up to 12 months. Aim: The aim of this study was to determine whether in utero IFX or ADA exposure results in an impaired immune response in infants, as measured by immunoglobulin levels and antibody responses to routine primary immunizations. Methods: Infants who were exposed to in utero anti-TNFα agents were prospectively evaluated. Immunoglobulin levels (IgG, IgM, IgA) and antibodies to standard vaccinations, including tetanus toxoid (tetanus) and Haemophilus influenza type b (Hib), were measured in infants of at least 6 months of age. Results: Twelve infants were prospectively studied: 10 exposed to in utero IFX and 2 exposed to ADA with at least one dose administered in the third trimester. Immunoglobulin levels were available on 10/12 patients, with all showing adequate immunoglobulin levels, except for low IgM levels in 5 (50 %) infants. Adequate responses to both the tetanus and Hib vaccines were seen in 11 of 12 (92 %) infants. Conclusions: Infants exposed to anti-TNFα agents in utero demonstrate appropriate response to two commonly administered neonatal vaccines and show adequate immunoglobulin levels, except for IgM. Newborns with a history of exposure to anti-TNFα agents should follow a standard vaccination schedule for inactive vaccines.
AB - Background: Infliximab (IFX) and adalimumab (ADA) cross the placenta in the third trimester and can be detectable in infants for up to 12 months. Aim: The aim of this study was to determine whether in utero IFX or ADA exposure results in an impaired immune response in infants, as measured by immunoglobulin levels and antibody responses to routine primary immunizations. Methods: Infants who were exposed to in utero anti-TNFα agents were prospectively evaluated. Immunoglobulin levels (IgG, IgM, IgA) and antibodies to standard vaccinations, including tetanus toxoid (tetanus) and Haemophilus influenza type b (Hib), were measured in infants of at least 6 months of age. Results: Twelve infants were prospectively studied: 10 exposed to in utero IFX and 2 exposed to ADA with at least one dose administered in the third trimester. Immunoglobulin levels were available on 10/12 patients, with all showing adequate immunoglobulin levels, except for low IgM levels in 5 (50 %) infants. Adequate responses to both the tetanus and Hib vaccines were seen in 11 of 12 (92 %) infants. Conclusions: Infants exposed to anti-TNFα agents in utero demonstrate appropriate response to two commonly administered neonatal vaccines and show adequate immunoglobulin levels, except for IgM. Newborns with a history of exposure to anti-TNFα agents should follow a standard vaccination schedule for inactive vaccines.
KW - Anti-TNFα
KW - Immune response
KW - Inflammatory bowel disease
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=84952657613&partnerID=8YFLogxK
U2 - 10.1007/s10620-015-3992-2
DO - 10.1007/s10620-015-3992-2
M3 - Article
C2 - 26725061
AN - SCOPUS:84952657613
SN - 0163-2116
VL - 61
SP - 1622
EP - 1627
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 6
ER -