Takahashi Kenichiro, Fujimoto Takehide, Shioya Makoto, Nishida Atsushi, Bamba Shigeki, Inatomi Osamu, Imaeda Hirotsugu, Kitoh Katsuyuki, Andoh Akira
Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, 520-2192, Japan.
Clin J Gastroenterol. 2015 Apr;8(2):88-91. doi: 10.1007/s12328-015-0558-y. Epub 2015 Mar 21.
There are few reports about the rapid appearance of anti-adalimumab antibodies in patients with Crohn's disease positive for anti-infliximab antibodies. We report the case of a 29-year-old female patient with a diagnosis of Crohn's disease who revealed a loss of response to infliximab due to high levels of antibodies to infliximab, and did not respond to the subsequent therapy by adalimumab, with a rapid appearance of antibodies to adalimumab. As one of the possible mechanisms of non-response to adalimumab, immunologic reactivity of infliximab to adalimumab was suspected, since the patient's IgG that was obtained just before the induction of adalimumab reacted with infliximab and adalimumab. We should pay attention to the easy appearance of anti-adalimumab antibodies in association with reactivity of anti-infliximab antibodies to adalimumab in patients with high levels of anti-infliximab antibodies.
关于抗英夫利昔单抗抗体呈阳性的克罗恩病患者中迅速出现抗阿达木单抗抗体的报道很少。我们报告了一例29岁诊断为克罗恩病的女性患者，该患者因抗英夫利昔单抗抗体水平高而对英夫利昔单抗失去反应，并且对随后的阿达木单抗治疗也无反应，同时迅速出现了抗阿达木单抗抗体。作为对阿达木单抗无反应的一种可能机制，怀疑英夫利昔单抗与阿达木单抗之间存在免疫反应性，因为在开始使用阿达木单抗之前获取的患者IgG与英夫利昔单抗和阿达木单抗都发生了反应。对于抗英夫利昔单抗抗体水平高的患者，我们应注意抗英夫利昔单抗抗体与阿达木单抗之间的反应性会导致抗阿达木单抗抗体容易出现。
