Paediatric Infectious Diseases, University Children's Hospital Mannheim, Heidelberg University, Germany.
Acta Neurol Scand. 2013 Jan;127(1):e1-4. doi: 10.1111/ane.12004. Epub 2012 Sep 5.
Pregnancies in women with severe relapsing-remitting multiple sclerosis treated with natalizumab constitute a major challenge, because withdrawal of the drug may cause relapses but continuation might have unknown effects on the infantile immune system.
To identify the impact of maternal natalizumab treatment during pregnancy on basic immune functions of the newborn.
Basic immunological testing and assessment of the chemotaxis rate of freshly isolated T lymphocytes in the presence and absence of CXCL12 was performed in two neonates, whose mothers were treated with natalizumab until the 34th week of pregnancy (pw).
Both children had an uneventful birth. However, a reduction in the CXCL12-induced T-cell chemotaxis was found in both children. In contrast, the chemotaxis rate of unstimulated T lymphocytes was not altered. The distribution of the lymphocyte subpopulations was investigated only in case 1 and was normal.
Here, we present to our knowledge the first assessment of T lymphocytes chemotaxis rate in two natalizumab-exposed newborns. A significant reduction in the CXCL12-induced chemotaxis rate of T lymphocytes has been observed and may compromise host defence function in early life. More clinical and immunological data on natalizumab-exposed neonates are warranted.
用那他珠单抗治疗的严重复发缓解型多发性硬化症女性患者妊娠是一个主要挑战，因为停药可能导致复发，但继续用药可能对婴儿免疫系统产生未知影响。
确定母亲妊娠期间使用那他珠单抗治疗对新生儿基本免疫功能的影响。
对两名新生儿进行基本免疫学检测，并在存在和不存在 CXCL12 的情况下评估新分离的 T 淋巴细胞趋化率，其母亲在妊娠第 34 周前一直接受那他珠单抗治疗。
两名儿童均顺利出生。然而，在两名儿童中均发现 CXCL12 诱导的 T 细胞趋化率降低。相比之下，未受刺激的 T 淋巴细胞趋化率未发生改变。仅对病例 1 进行了淋巴细胞亚群分布的调查，结果正常。
在此，我们首次评估了两名那他珠单抗暴露新生儿的 T 淋巴细胞趋化率。观察到 CXCL12 诱导的 T 淋巴细胞趋化率显著降低，这可能会损害早期生命的宿主防御功能。需要更多的临床和免疫学数据来评估那他珠单抗暴露的新生儿。
