Humoral Immune Response after a Booster Dose with Tdap in Children and Adolescents with Juvenile Idiopathic Arthritis on Anti-TNF and in Healthy Controls

Aline Nicacio¹, Octavio Peracchi², Juliana Yamada³, Fernanda Spina³, Brunna Alvarenga³, Maria Isabel Pinto³ and Maria Teresa Terreri⁴, ¹Pediatric Rheumatology Unit, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil, Sao Paulo, Brazil, ²Pediatric Rheumatology, Federal University of Sao Paulo, Department of Pediatrics, Sao Paulo, Brazil, Sao Paulo, Brazil, ³Federal University of Sao Paulo, Department of Pediatrics, Sao Paulo, Brazil, Sao Paulo, Brazil, ⁴Pediatric Rheumatology Unit, Federal University of São Paulo, São Paulo, Brazil

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: immune response, juvenile idiopathic arthritis (JIA) and vaccines

Session Information

Date: Sunday, November 13, 2016

Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects - Poster I: Juvenile Idiopathic Arthritis, Uveitis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Pertussis cases have increased worldwide and knowledge on immune response after adult Tdap vaccine is scarce. This study evaluated the humoral immune response profile after Tdap in children and adolescents with Juvenile Idiopathic Arthritis and in healthy controls.

Methods: After written informed consent, children and adolescents with Juvenile Idiopathic Arthritis (JIA) using anti-TNF and healthy controls (control) with three previous whole-cell DTP plus two booster vaccine doses received a Tdap dose. Blood samples were collected immediately before and 28 days after Tdap. Tetanus, diphtheria and pertussis antibodies were tested by ELISA. Antibodies>0.100 IU/mL were considered protective for tetanus and diphtheria. There isn’t a consensus antibodies level considered protective for pertussis.

Results: JIA group (n=10) was represented for 7 (70%) female, with median age 13 (8-18), 4 (40%) with positive anti-nuclear antibodies (ANA), 1 (10%) with positive rheumatoid factor. Control group (n=9) was represented for 4 (44.4%) female, with median age 15.2 (9-15.6). JIA and control groups presented an increase in response to tetanus (p=0.0004, p=0.002) and diphtheria (p<0.0001, p=0.002) antibodies after Tdap booster dose on day 28 and were comparable in the proportion of immune subjects on day 0 (p=0.1226, p=0.3322) and on day 28 (p=0.3493, p=0.5). Everyone in both groups seroconverted to tetanus and diphtheria. In JIA group median antibodies level for pertussis were 10.796 IU/mL (2.4-197.09) and 83.8 IU/mL (8.4-196.69) on day 0 and day 28. In the control group median antibodies level for pertusis were 8.47 IU/mL (1.08-108.88) and 59.73 IU/mL (13.87-138.04) on day 0 and day 28.

Conclusion: In this preliminary study, children and adolescents with JIA using anti-TNF and healthy controls showed adequate humoral immune response to tetanus, diphtheria and pertussis after Tdap. Future research include increasing sample size correlating T follicular cells population with improved humoral immune response.

Disclosure: A. Nicacio, None; O. Peracchi, None; J. Yamada, None; F. Spina, None; B. Alvarenga, None; M. I. Pinto, None; M. T. Terreri, None.

To cite this abstract in AMA style:

Nicacio A, Peracchi O, Yamada J, Spina F, Alvarenga B, Pinto MI, Terreri MT. Humoral Immune Response after a Booster Dose with Tdap in Children and Adolescents with Juvenile Idiopathic Arthritis on Anti-TNF and in Healthy Controls [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/humoral-immune-response-after-a-booster-dose-with-tdap-in-children-and-adolescents-with-juvenile-idiopathic-arthritis-on-anti-tnf-and-in-healthy-controls/. Accessed .

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