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胎儿在子宫内暴露于母亲(器官接受者)所使用的免疫抑制药物,是否会影响这些母亲的孩子在出生后对特定病毒性疾病的疫苗接种后免疫力的发展?

Does Intrauterine Exposure of the Foetus to Immunosuppressive Drugs Used by the Mother-The Organ Recipient-Affect the Development of Post-Vaccination Immunity against Selected Viral Diseases in Children of These Mothers in Postnatal Life?

作者信息

Ginda Tomasz, Taradaj Karol, Stelmaszczyk-Emmel Anna, Tronina Olga, Kociołek Patrycja, Jendro Oliver, Kociszewska-Najman Bożena

机构信息

Department of Neonatology and Rare Diseases, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland.

Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland.

出版信息

Vaccines (Basel). 2023 Mar 27;11(4):738. doi: 10.3390/vaccines11040738.

Abstract

BACKGROUND

Pregnancy in women who are organ recipients has long been a controversial issue due to the lack of data on the safety of immunosuppressive drugs for the developing foetus. Scientific data show that the effect of immunosuppressants on the foetus causes an impairment of T and B lymphocyte function and a reduction in their total number. For this reason, some authors recommend delaying the obligatory immunization of infants. The aim of the study is to analyse the impact of chronic immunosuppressive therapy used during pregnancy by women after organ transplantation on the effectiveness of anti-viral vaccinations in the children of these women.

METHODS

Concentrations of post-vaccination IgG antibodies (measles, HBV, polio) in 18 children of post-transplant mothers (9KTRs; 9LTRs) were determined using the ELISA method. The results were compared with the control group ( = 21). The incidence of vaccination AEs was also analysed.

RESULTS

There were no significant differences between the analysed groups in the concentrations of antibodies against HBV, measles and polio ( > 0.05).

CONCLUSIONS

No difference was observed in the immunogenicity of HBV, polio and measles vaccinations between children of post-transplant mothers and the general population. The immunization of children of post-transplant mothers is safe, and the percentage of adverse post-vaccination events does not differ from the general population. The obtained study results do not indicate the necessity for modifying the vaccination program for HBV, measles, and polio in this group of patients.

摘要

背景

由于缺乏免疫抑制药物对发育中胎儿安全性的数据,器官移植受者女性怀孕长期以来一直是一个有争议的问题。科学数据表明,免疫抑制剂对胎儿的影响会导致T和B淋巴细胞功能受损以及其总数减少。因此,一些作者建议推迟婴儿的强制免疫。本研究的目的是分析器官移植后女性在孕期使用的慢性免疫抑制治疗对这些女性子女抗病毒疫苗接种效果的影响。

方法

采用ELISA法测定18名移植后母亲的子女(9名肾移植受者;9名单肺移植受者)接种疫苗后IgG抗体(麻疹、乙肝、脊髓灰质炎)的浓度。将结果与对照组(n = 21)进行比较。还分析了疫苗接种不良事件的发生率。

结果

分析组之间针对乙肝、麻疹和脊髓灰质炎的抗体浓度无显著差异(P>0.05)。

结论

移植后母亲的子女与普通人群在乙肝、脊髓灰质炎和麻疹疫苗接种的免疫原性方面未观察到差异。移植后母亲的子女接种疫苗是安全的,接种后不良事件的发生率与普通人群无差异。本研究结果未表明有必要修改该组患者的乙肝、麻疹和脊髓灰质炎疫苗接种方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/10140814/e0210c371efc/vaccines-11-00738-g001.jpg

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