Navegando por Palavras-chave "Vaccines against diphteria, tetanus and acellular pertussis"

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    Estudo da imunogenicidade e da segurança da vacina tríplice bacteriana acelular em adolescentes com lupus eritematoso sistêmico juvenil
    (Universidade Federal de São Paulo (UNIFESP), 2018-12-06) Peracchi, Octavio Augusto Bedin [UNIFESP]; Terreri, Maria Teresa de Sande e Lemos Ramos Ascensao [UNIFESP]; Pinto, Maria Isabel de Moraes [UNIFESP]; http://lattes.cnpq.br/0967318191677557; http://lattes.cnpq.br/2661280959330284; http://lattes.cnpq.br/0846892433278057; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The topic immunization in immunosuppressed patients, such as juvenile systemic lupus erythematosus (jSLE), remains highly discussed and it is necessary to protect these individuals against agents to which they are particularly susceptible. Objective: The aim of this study was to evaluate the immunogenicity and safety of the diphtheria, tetanus and acellular pertussis (Tdap) vaccine in adolescents with jSLE and in healthy adolescents. Methods: A prospective longitudinal observational study in which two groups of individuals were evaluated: one of adolescents with jSLE according to Hochberg and SLICC classification criteria (jSLE, n = 26) and a group of healthy adolescents (control, n = 26) compared with the case group by age and sex. A 0.5 ml dose of the diphtheria, tetanus, acellular pertussis (dTpa) vaccine was administered intramuscularly to the non-dominant arm of the selected subjects. Samples of 10 mL of peripheral blood were collected on the day of vaccination (D0) and after 14 days (D14), 28 days (D28), 6 months (D6m) and 12 months (D12m) of the vaccination. Serologies for tetanus, diphtheria and pertussis, immunophenotyping of lymphocytes in peripheral blood and evaluation of cytokines were assessed. The adverse events were assessed in both groups and the disease activity in the jSLE group. Results: There was no difference in the frequency of adverse events between the jSLE group and the control group (p=0.999). When evaluating the disease activity, no difference was found in the mean values of SLEDAI at the D0 to the D28 (p=0.151), D6m (p=0.782) and D12m (p=0.812). No difference was observed in the geometric means of the Tfh cells concentrations per group and at D0 and D14. Both groups showed a significant increase in antibody levels for the three antigens (p<0.001) in D14 and D28. The groups had distinct evolutions for tetanus and pertussis (p=0.004 and p<0.001, respectively). For tetanus and diphtheria, in D14 more than 95% of the patients presented protection and all of them presented in D28. For pertussis, the frequency of seroconversion did not differ in D14 (54%) and D28 (63%), and in D12m this frequency decreased statistically (p=0.004). Patients had significantly lower levels of IFNƔ (p<0.001) and higher IL10 (p=0.001), IL12 (p=0.002), IL21 (p=0.038) and TNFα (p=0.008). Conclusion: Patients with jSLE had a good response to a booster dose with the dTpa vaccine for diphtheria and tetanus antigens, but not for pertussis. This vaccine was shown to be safe in relation to adverse events and absence of reactivation of the disease.