Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
Inflamm Bowel Dis. 2013 Feb;19(2):418-22. doi: 10.1002/ibd.23027.
Few studies have measured the levels of antibodies specific for measles, mumps, rubella, and varicella zoster/chickenpox viruses in inflammatory bowel disease (IBD) patients undergoing treatment with immunomodulators/biologics.
We prospectively recruited 139 IBD outpatients. Enzyme-linked immunosorbent assays were used as the serological tests for measles, mumps, rubella, and varicella zoster. We defined anti-rubella IgG < 10 IU/mL, anti-measles IgG < 16 IU/mL, and anti-mumps/varicella zoster IgG <4 IU/mL as seronegative for viruses. We also asked participants about past immunizations against or infections with measles, mumps, rubella, and varicella zoster viruses.
The proportion of patients with seronegative levels of antibodies specific for varicella zoster, rubella, measles, and mumps viruses was 5%, 30%, 34%, and 37%, respectively. Approximately 40% of the IBD patients did not remember whether they had previously been infected with any of the viruses, and almost one-third of the patients could not remember whether they had previously been vaccinated. Almost 30% of the patients with a past history of rubella or measles did not have seropositive antibody levels. A total of 54% of the patients being treated with immunosuppressant displayed seronegative levels of antibodies specific for at least one of the viruses.
Many IBD patients were unaware of whether they had previously been vaccinated against or infected with the viruses causing varicella zoster, rubella, measles, or mumps. Therefore, measuring the current levels of antibodies specific for such viruses is useful for determining whether patients have seropositive antibody levels before immunomodulators/biologics are used for therapy.
在接受免疫调节剂/生物制剂治疗的炎症性肠病(IBD)患者中,很少有研究测量针对麻疹、腮腺炎、风疹和水痘带状疱疹/水痘病毒的特异性抗体水平。
我们前瞻性地招募了 139 名 IBD 门诊患者。酶联免疫吸附试验(ELISA)被用作麻疹、腮腺炎、风疹和水痘带状疱疹的血清学检测。我们将抗风疹 IgG<10IU/mL、抗麻疹 IgG<16IU/mL 和抗腮腺炎/水痘带状疱疹 IgG<4IU/mL 定义为病毒血清阴性。我们还询问了参与者过去是否接种过麻疹、腮腺炎、风疹和水痘带状疱疹病毒疫苗,以及是否感染过这些病毒。
水痘带状疱疹、风疹、麻疹和腮腺炎病毒特异性抗体血清阴性的患者比例分别为 5%、30%、34%和 37%。约 40%的 IBD 患者不记得自己是否曾感染过这些病毒中的任何一种,近三分之一的患者不记得自己是否曾接种过疫苗。近 30%的有风疹或麻疹既往史的患者没有血清阳性抗体水平。过去曾有过风疹或麻疹病史的患者中,有 54%的患者的至少一种病毒特异性抗体呈血清阴性。共有 54%的接受免疫抑制剂治疗的患者存在至少一种病毒的特异性抗体血清阴性。
许多 IBD 患者不知道自己是否曾接种过预防水痘带状疱疹、风疹、麻疹或腮腺炎病毒的疫苗,或者是否曾感染过这些病毒。因此,在使用免疫调节剂/生物制剂进行治疗之前,测量针对这些病毒的特异性抗体的当前水平有助于确定患者是否具有血清阳性抗体水平。