Kopsidas Ioannis, Mentesidou Lida, Syggelou Angeliki, Papadimitriou Maria, Matsas Minos, Kossiva Lydia, Maritsi Despoina N
Infectious Diseases, Immunology and Rheumatology Unit, Second Department of Pediatrics, ''P. & A. Kiriakou" Children's Hospital, Athens Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece.
1st Department of Pediatrics, "P. & A. Kiriakou" Children's Hospital, Thivon 1 and Levadias, Goudi, 11527, Athens, Greece.
Rheumatol Int. 2024 Dec;44(12):3027-3033. doi: 10.1007/s00296-024-05563-y. Epub 2024 Mar 18.
Novel treatments have revolutionized the care and outcome of patients with juvenile idiopathic arthritis (JIA). Patients with rheumatic diseases are susceptible to infections, including vaccine preventable ones, due to waning immunity, failing immune system and immunosuppressive treatment received. However, data regarding long-term immunological memory and response to specific vaccines are limited. Assessment of the impact of methotrexate (MTX) treatment on measles-specific-IgG titers, in children with oligo-JIA previously vaccinated with Measles Mumps Rubella (MMR) vaccine (1 dose); by evaluating the persistence of antibodies produced after measles vaccination while on immunomodulating treatment at 0, 12 and 24 months. Single-center controlled study including 54 oligo-JIA patients and 26 healthy controls. Seroprotection rates and measles-specific-IgG titers were measured by ELISA and were expressed as GMCs (Geometric Mean Concentrations).The two groups had similar demographic characteristics, vaccination history and immunization status. Seroprotection rates were adequate for both groups. Nonetheless, measles GMCs were significantly lower in the oligo-JIA compared to the control group at one (p = 0.039) and two years' follow-up (p = 0.021). Children with oligo-JIA on MTX treatment appeared to have lower measles-specific-IgG titers. Further studies are required to assess the long-term immunity conveyed by immunizations given at an early stage in children with rheumatic diseases on synthetic Disease Modifying Antirheumatic Drugs (sDMARDs) and to assess the need for booster doses to subjects at risk.
新型治疗方法彻底改变了青少年特发性关节炎（JIA）患者的护理和治疗结果。由于免疫功能下降、免疫系统衰竭以及接受免疫抑制治疗，风湿病患者易受感染，包括可通过疫苗预防的感染。然而，关于长期免疫记忆和对特定疫苗反应的数据有限。通过评估在0、12和24个月接受免疫调节治疗期间接种麻疹疫苗后产生的抗体持久性，来评估甲氨蝶呤（MTX）治疗对先前接种过麻疹腮腺炎风疹（MMR）疫苗（1剂）的少关节型JIA儿童麻疹特异性IgG滴度的影响。单中心对照研究，纳入54例少关节型JIA患者和26例健康对照。通过ELISA检测血清保护率和麻疹特异性IgG滴度，并以几何平均浓度（GMCs）表示。两组在人口统计学特征、疫苗接种史和免疫状态方面相似。两组的血清保护率均足够。尽管如此，在1年（p = 0.039）和2年随访（p = 0.021）时，少关节型JIA组的麻疹GMCs显著低于对照组。接受MTX治疗的少关节型JIA儿童的麻疹特异性IgG滴度似乎较低。需要进一步研究来评估在患有风湿病的儿童早期使用合成改善病情抗风湿药物（sDMARDs）进行免疫接种所传达的长期免疫力，并评估对有风险的受试者进行加强剂量接种的必要性。
