免疫调节药物对母亲接种Tdap疫苗诱导婴儿抗体的影响。

IF 8.7
Jantien W Wieringa, Mirjam J Esser, Gerco den Hartog, M Alina Nicolaie, Lyanne W Rövekamp, Esther G J Rijntjes-Jacobs, Ron H T van Beek, Gerdien A Tramper-Stranders, Marjan Kuijer, Maarten M Immink, Nicoline A T van der Maas, Nynke Y Rots, Gertjan J A Driessen
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引用次数: 0

摘要

背景和目的:目前关于炎症性肠病(IBD)的国际指南建议在怀孕期间继续使用免疫调节药物。关于这种药物对产妇破伤风-白喉-无细胞百日咳疫苗接种和向婴儿转移抗体的影响的数据很少。方法:2018年12月至2023年3月期间,在荷兰16家医院的PETIT研究队列中前瞻性地招募了接受各种免疫调节药物治疗的IBD孕妇及其婴儿。根据荷兰国家免疫规划,所有妇女都接种了百白破疫苗。在出生时(母血和脐带血)和婴儿2个月大时(主动免疫前)测量针对所有Tdap成分的IgG浓度。我们比较了ibd母亲-婴儿对与健康对照母亲-婴儿对的几何平均浓度(GMCs)。结果:在所有时间点,135名接种过疫苗的母亲及其婴儿的抗Tdap所有成分抗体的gmc显著高于25对未接种过ibd疫苗并在怀孕期间接受免疫调节药物治疗的母婴对。然而,接种ibd疫苗的母婴对抗PRN的GMC显著低于健康接种疫苗的对照组母婴对,特别是在接受抗肿瘤坏死因子α (anti-TNFα)治疗的母亲及其婴儿中。结论:妊娠期接受免疫调节药物治疗的IBD母亲接种Tdap疫苗,其婴儿的Tdap抗体浓度明显高于未接种IBD母亲的婴儿,尽管PRN的GMC低于健康对照组。这些结果支持目前建议接受免疫调节药物的孕妇接种百白破疫苗的建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants.

Background and aims: Current international guidelines on inflammatory bowel disease (IBD) advise to continue immunomodulating medication during pregnancy. Data on the effect of this medication on maternal Tdap (Tetanus-Diphtheria-acellular pertussis) vaccination and transfer of antibodies to the infant are scarce.

Methods: Pregnant women with IBD receiving various immunomodulating medications and their infants were prospectively recruited in the Pregnancy Exposure to TNF alpha inhibitors and Immunological effect (PETIT) study cohort from 16 hospitals in the Netherlands between December 2018 and March 2023. All women were offered maternal Tdap vaccination according to the Dutch National Immunization Program. IgG concentrations against all Tdap components were measured at birth (maternal and cord blood) and at 2 months of age in the infant, preceding active immunization. We compared geometrical mean concentrations (GMCs) in IBD mother-infant pairs with healthy control mother-infant pairs.

Results: Geometrical mean concentrations of antibodies against all Tdap components were significantly higher in 135 maternally vaccinated mothers and their infants compared with 25 unvaccinated IBD women-infant pairs treated with immunomodulating medication during pregnancy, at all timepoints. However, GMC against pertactin (PRN) was significantly lower in vaccinated IBD mother-infant pairs compared to healthy vaccinated control mother-infant pairs, particularly in mothers treated with anti-tumor necrosis factor alpha and their infants.

Conclusions: Maternal Tdap vaccination in women with IBD receiving immunomodulating medication during pregnancy results in significantly higher Tdap-antibody concentrations in their infants compared to infants of unvaccinated IBD mothers, although GMC was lower for PRN compared to healthy controls. These results support current recommendations to advise maternal Tdap vaccination in pregnant women receiving immunomodulating medication.

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