Navegando por Palavras-chave "Vaccines against diphtheria"

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    Estudo da imunogenicidade e segurança da vacina tríplice bacteriana acelular do adulto (dTpa) em crianças e adolescentes com artrite idiopática juvenil (AIJ)
    (Universidade Federal de São Paulo (UNIFESP), 2017-05-25) Nicacio, Aline Alencar Martins Fernandes [UNIFESP]; Terreri, Maria Teresa de Sande e Lemos Ramos Ascensão [UNIFESP]; Pinto, Maria Isabel de Moraes [UNIFESP]; http://lattes.cnpq.br/0967318191677557; http://lattes.cnpq.br/2661280959330284; http://lattes.cnpq.br/1618399462513631; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in childhood, accounting for varying degrees of physical disability. Protection of infections through active immunization is essential in patients with JIA using immunosuppressive drugs. However, there are still doubts about indication, safety and efficacy, as well as reactivation of the disease in this group of patients when using these vaccines. Objectives: The aim of this study was to evaluate the immunogenicity and safety of adult acellular bacterial triple vaccine (dTpa) in patients with JIA with or without use of anti-TNF agents. Methods: This is a prospective longitudinal experimental study in which three groups of individuals were assessed: one with patients with JIA according to ILAR criteria using anti-TNF agent (n=19), another with JIA patients without use of anti-TNF agent (n=19) and another from healthy individuals (Control, n=27), paired with case groups by age and gender. A 0.5 ml dose of the diphtheria, tetanus, acellular pertussis (dTpa) adsorbed vaccine (ADACEL® Sanofi Pasteur, Toronto, Canada) was administered intramuscularly in the non-dominant arm of the selected subjects. Samples of 10 mL of peripheral blood were collected on the day of vaccination (D0), after 14 days (D14) and 28 days after vaccination (D28). Serology for tetanus, diphtheria and pertussis and immunophenotyping of lymphocytes in peripheral blood were performed. Results: Patients with and without anti-TNF agents did not present significant differences in the frequency of ANA (anti-nuclear antibody), RF (rheumatoid factor) and presence of uveitis. There was only association between use of anti-TNF and course subtype (p = 0.009). Thus, it was observed that patients without anti-TNF had a higher percentage of persistent oligo (36.8% vs 0%) and lower ERA frequency (0.0% vs 21.1%) compared to the group onf anti-TNF. In the group on anti-TNF agent, about half were on fusion protein (etanercept), while the other half were on monoclonal antibody (adalimumab or infliximab). We did not observe reactivation of the disease after vaccination. We observed presence of adverse events in about one third of the individuals, being pain at the site of the vaccine the most prevalent. Differences in the immunophenotypic profile were observed, but without repercussion in the humoral immune response to the three antigens evaluated. Conclusion: The subjects with JIA with or without use of anti-TNF agents showed a good response to a booster dose for the three antigens studied in the absence of major adverse events and without reactivation of the disease.