Measles-specific antibodies loss after a single dose of MMR vaccine in children with oligo-articular JIA on methotrexate treatment: a single-center case-controlled study

Ioannis Kopsidas1, Lida Mentesidou2, Angeliki Syggelou1, Maria Papadimitriou3, Minos Matsas3, Lydia Kossiva1, Despoina N. Maritsi1,4
1Infectious 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
21st Department of Pediatrics, “P. & A. Kiriakou” Children’s Hospital, Athens, Greece
3Department of Serology, “P. & A. Kiriakou” Children’s Hospital, Athens, Greece
4Rheumatology Unit, “Archbishop Makarios III” Children’s Hospital, Nicosia, Cyprus

Tóm tắt

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.

Từ khóa


Tài liệu tham khảo

Cimaz R (2016) Systemic-onset juvenile idiopathic arthritis. Autoimmun Rev 15(9):931–4. https://doi.org/10.1016/j.autrev.2016.07.004. (Epub 2016 Jul 6 PMID: 27392503) Makarova E, Khabirova A, Volkova N, Gabrusskaya T, Ulanova N, Sakhno L, Revnova M, Kostik M (2023) (2023) Vaccination coverage in children with juvenile idiopathic arthritis, inflammatory bowel diseases, and healthy peers: cross-sectional electronic survey data. World J Clin Pediatr 12(2):45–56. https://doi.org/10.5409/wjcp.v12.i2.45 Bizjak M, Heshin-Bekenstein M, Jansen MHA, Ziv A, Angevare S, Uziel Y, Ulffraat NM, Toplak N (2023) PReS vaccination working party vaccinology in pediatric rheumatology past present and future. Front Pediatr. 10:1098332 Hübschen JM, Gouandjika-Vasilache I, Dina J (2022) Measles. Lancet 399(10325):678–690. https://doi.org/10.1016/S0140-6736(21)02004-3. (Epub 2022 Jan 28 PMID: 35093206) Mina MJ, Metcalf CJE, de Swart RL, Osterhaus ADME, Grenfell BT (2015) (2015) Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science 348(6235):694–699. https://doi.org/10.1126/science.aaa3662 Petty RE, Southwood TR, Manners P et al (2004) International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision Edmonton 2001. J Rheumatol 31(2):390–2 Quach HQ, Ovsyannikova IG, Grill DE, Warner ND, Poland GA, Kennedy RB (2022) Seroprevalence of measles antibodies in a highly MMR-vaccinated population. Vaccines 10:11–1859. https://doi.org/10.3390/vaccines10111859 Shoop-Worrall SJW, Kearsley-Fleet L, Thomson W, Verstappen SMM, Hyrich KL (2017) How common is remission in juvenile idiopathic arthritis: a systematic review. Semin Arthritis Rheum 47(3):331–337. https://doi.org/10.1016/j.semarthrit.2017.05.007. (Epub 2017 May 20. PMID: 28625712; PMCID: PMC5687936) Maritsi DN, Eleftheriou I, Vartzelis G, Spyridis N, Tsolia MN (2019) (2019) Risk factors associated with accelerated rubella igg antibody loss in previously vaccinated, treatment-naive patients With juvenile systemic Lupus Erythematosus: a prospective study. Arthritis Rheumatol 71(6):1022–1023. https://doi.org/10.1002/art.40831 Campos LMA, Silva CA, Aikawa NE et al (2013) (2013) High disease activity: an independent factor for reduced immunogenicity of the pandemic influenza a vaccine in patients with juvenile systemic Lupus Erythematosus: H1N1/2009 vaccine in Juvenile SLE. Arthr Care Res 65(7):1121–1127. https://doi.org/10.1002/acr.21948 Bizjak M, Heshin-Bekenstein M, Jansen MHA, Ziv A, Angevare S, Uziel Y, Wulffraat NM, Toplak N (2022) PReS vaccination working party vaccinology in pediatric rheumatology: past, present and future. Front Pediatr 10:1098332. https://doi.org/10.3389/fped.2022.1098332 Aikawa NE, Campos LMA, Silva CA et al (2012) Glucocorticoid: major factor for reduced immunogenicity of 2009 influenza A (H1N1) vaccine in patients with juvenile autoimmune rheumatic disease. J Rheumatol 39(1):167–173. https://doi.org/10.3899/jrheum.110721 Cleveland NK, Rodriquez D, Wichman A, Pan I, Melmed GY, Rubin DT (2016) (2016) Many inflammatory bowel disease patients are not immune to measles or pertussis. Dig Dis Sci 61:2972–6. https://doi.org/10.1007/s10620-016-4275-2 Maritsi DN, Vartzelis G, Kopsidas J, Spyridis N, Tsolia MN (2018) (2018) Antibody status against measles in previously vaccinated childhood systemic Lupus erythematosus patients: a prospective case-control study. Rheumatology 57(8):1491–1493. https://doi.org/10.1093/rheumatology/key142 Maritsi DN, Kopsidas I, Vartzelis G, Spyridis N, Tsolia MN (2019) (2019) Long-term preservation of measles and rubella specific-IgG antibodies in children with enthesitis related arthritis on anti-TNFα treatment: a prospective controlled study. Rheumatology 58(9):1686–1688. https://doi.org/10.1093/rheumatology/kez096 Maritsi D, Coffin S, Onoufriou M, Spyridis N, Tsolia M (2018) Decreased antibodies against rubella in previously vaccinated treatment-naïve childhood systemic lupus erythematous patients: a prospective case–control study. Scand J Rheumatol 48:74–76. https://doi.org/10.1080/03009742.2018.1446100 Ramos-Casals M, Cuadrado MJ, Alba P et al (2008) (2008) Acute viral infections in patients with systemic Lupus erythematosus: description of 23 cases and review of the literature. Medicine 87:311–318. https://doi.org/10.1097/MD.0b013e31818ec711 Agrati C, Bartolini B, Bordoni V, Locatelli F, Capobianchi MR, Di Caro A, Castilletti C, Ippolito G (2023) Emerging viral infections in immunocompromised patients: a great challenge to better define the role of immune response. Front Immunol 14:1147871. https://doi.org/10.3389/fimmu.2023.1147871 Backström M, Tynjälä P, Ylijoki H et al (2016) (2016) Finding specific 10-joint juvenile arthritis disease activity score (JADAS10) and clinical JADAS10 cut-off values for disease activity levels in non-systemic juvenile idiopathic arthritis: a Finnish multicentre study. Rheumatology 55(4):615–623. https://doi.org/10.1093/rheumatology/kev353 Heijstek MW, Kamphuis S, Αrmbrust W et al (2013) Effects of the live attenuated measles-mumps-rubella booster vaccination on disease activity in patients with juvenile idiopathic arthritis: a randomized trial. J Am Med Assoc 309(23):2449–2456. https://doi.org/10.1001/jama.2013.6768 Hamad Saied M, van Straalen JW, de Roock S, de Joode-Smink GCJ, Verduyn Lunel FM, Swart JF, Wulffraat NM, Jansen MHA (2023) Long-term immunoprotection after live attenuated measles-mumps-rubella booster vaccination in children with juvenile idiopathic arthritis. Vaccine 41(37):5477–5482. https://doi.org/10.1016/j.vaccine.2023.07.052. (Epub 2023 Jul 27 PMID: 37516575) Cunninghame J, Wen S, Dufficy M et al (2023) Immunogenicity and safety of vaccination in children with paediatric rheumatic diseases: a scoping review. Ther Adv Vaccine Immunother 2023:11. https://doi.org/10.1177/25151355231167116