期刊
CLINICAL IMMUNOLOGY
卷 118, 期 1, 页码 11-19出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.clim.2005.07.010
关键词
Crohn's disease; TNF-alpha; infliximab therapy; anaphylaxis
类别
Tumor necrosis factor (TNF)-alpha plays a critical role in the initiation and progression of Crohn's disease: a chronic inflammatory disorder of the gastrointestinal tract. Infliximab, a chimeric monoclonal antibody blocking TNF-alpha, has proven effective as an induction and maintenance therapy for refractory Crohn's disease in adult and pediatric patients. However. infliximab therapy induces the appearance of neutralizing anti-infliximab antibodies. In the pediatric cohort, we analyzed (n = 28) sensitization occurred in 35.7% patients and was associated with a loss of response to maintenance infusions. In two patients presenting high titers of anti-infliximab antibodies, severe infusion reactions were observed, possibly IgE-mediated, precluding further use of the medication. Serum concentrations of TNF-a and infliximab were influenced by the presence of anti-infliximab antibodies. We propose that surveillance of circulating infliximab and/or TNIF-alpha concentration during maintenance therapy represents an indirect but reliable method to monitor anti-infliximab immunization. (c) 2005 Elsevier Inc. All rights reserved.
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