Cimaz R, Meregalli E, Biggioggero M, Borghi O, Tincani A, Motta M, Airò P, Meroni P L
Clinica Pediatrica, ICP, Via Commenda 9, Milan 20122, Italy.
Toxicol Lett. 2004 Apr 1;149(1-3):155-62. doi: 10.1016/j.toxlet.2003.12.030.
Many of the immunosuppressive drugs that are used during pregnancy can cross the placental barrier and enter the foetal circulation, with a possible impact on the foetal immune system. We have evaluated the immune function of children born from mothers treated with immunosuppressants for connective tissue diseases. A total of nine babies, whose six mothers had been taking cyclosporine A (two), azathioprine (one) and dexamethasone (three) during pregnancy, together with 14 babies from mothers with similar diseases but who had not been treated (controls) were investigated. Complete blood count, IgA, IgG, IgM, IgG subclasses, and lymphocyte subpopulations were determined in all cases. Moreover, serum levels of anti-HBsAg and presence of autoantibodies (ANA, ENA) were also evaluated. Patients were tested at a mean age of 11 months (range, 1-17). Only a minor proportion of our patients displayed low values for age (mainly, IgA and IgG2), but none of the parameters tested resulted significantly different in patients than in controls. All children responded satisfactorily to hepatitis B vaccination. Although our results are preliminary, we conclude that prenatal exposure to immunosuppressive drugs does not have a profound effect to the developing immune system. More data and a longer follow-up are needed to confirm these results.
许多在孕期使用的免疫抑制药物可穿过胎盘屏障进入胎儿循环，可能会对胎儿免疫系统产生影响。我们评估了患有结缔组织病的母亲在接受免疫抑制剂治疗后所生孩子的免疫功能。共调查了9名婴儿，其母亲中有6名在孕期服用了环孢素A（2名）、硫唑嘌呤（1名）和地塞米松（3名），同时还调查了14名来自患有相似疾病但未接受治疗的母亲的婴儿（对照组）。对所有病例均进行了全血细胞计数、IgA、IgG、IgM、IgG亚类和淋巴细胞亚群的检测。此外，还评估了抗HBsAg血清水平和自身抗体（ANA、ENA）的存在情况。对平均年龄为11个月（范围1 - 17个月）的患者进行了检测。我们的患者中只有一小部分显示出低于年龄标准的值（主要是IgA和IgG2），但所检测的参数在患者和对照组之间均无显著差异。所有儿童对乙肝疫苗接种反应良好。尽管我们的结果是初步的，但我们得出结论，产前接触免疫抑制药物对发育中的免疫系统没有深远影响。需要更多数据和更长时间的随访来证实这些结果。
