Anti-TNF and Thiopurine Therapy in Pregnant IBD Patients Does Not Significantly Alter a Panel of B-cell and T-cell Subsets in 1-year-old Infants

Overview

Journal Clin Transl Gastroenterol

Specialty Gastroenterology

Date 2018 Apr 6

PMID 29618720

Citations 8

Authors

Michael G Kattah

Jeffrey M Milush

Trevor Burt

Robert P McCabe Jr

Michael I Whang

Averil Ma

Uma Mahadevan

Affiliations

Soon will be listed here.

Abstract

Objectives: Infants exposed to combination therapy with anti-tumor necrosis factor (anti-TNF) agents and thiopurines may exhibit increased infections at 1 year of age compared to unexposed infants. We hypothesized that this increased risk of infection is due to abnormal development of the newborn immune system.

Methods: We immunophenotyped B-cell and T-cell subsets using multiparameter flow cytometry in 1-year-old infants whose mothers were exposed to therapeutic agents for IBD. We analyzed samples from infants exposed to infliximab (IFX) or adalimumab (ADA) monotherapy (IFX/ADA, n = 11), certolizumab pegol (CZP) monotherapy (CZP, n = 4), IFX or ADA plus thiopurine combination therapy (IFX/ADA + IM, n = 4), and CZP plus thiopurine combination therapy (CZP + IM, n = 2).

Results: Percentages of B cells, CD4 T helper cells, T regulatory cells (T), and CD8 cytotoxic T cells, were similar among the groups. Infants exposed to combination therapy (IFX/ADA + IM) exhibited trends toward fewer CD27 B cells, switched memory B cells, plasmablasts, interferon gamma (IFNγ)-producing CD4 and CD8 T cells, and CCR5CD4 T cells, but these did not reach statistical significance.

Conclusions: Multiparameter immunophenotyping of major B-cell and T-cell subsets suggests that the adaptive newborn immune system develops largely unaltered after exposure to combination therapy as compared to anti-TNF monotherapy.

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