JCC: 婴儿出生时脐带血中抗TNF水平对婴儿的生长发育影响甚小

2018-08-28 MedSci MedSci原创

炎症性肠病[IBD]患者的妊娠指南建议其在妊娠期间停止抗TNF的治疗,以限制胎儿暴露在其药物浓度中。虽然英夫利昔单抗[IFX]的脐带血中抗TNF浓度高于阿达木单抗[ADA],但本项目的是证明妊娠期间抗TNF治疗对于胎儿的影响不是十分明显。

背景和目标
炎症性肠病[IBD]患者的妊娠指南建议其在妊娠期间停止抗TNF的治疗,以限制胎儿暴露在其药物浓度中。虽然英夫利昔单抗[IFX]的脐带血中抗TNF浓度高于阿达木单抗[ADA],但本项目的是证明妊娠期间抗TNF治疗对于胎儿的影响不是十分明显。

方法
研究人员进行了一项前瞻性单中心队列研究,随访了怀孕期间使用IFX或ADA的IBD妇女。在疾病维持缓解的情况下,抗TNF治疗在妊娠晚期停止。出生时,测量脐带血中抗TNF浓度。使用线性回归模型以证明出生时脐带血中的抗TNF浓度。此外,本研究还收集了孕妇疾病活动,妊娠结局和婴儿1年健康结果等结果。

结果
本项研究纳入了131次怀孕[73 IFX,58 ADA]。出生时,获得了94份脐带血样本[52 IFX,42 ADA],结果显示IFX比ADA有着显着更高抗TNF水平。在妊娠晚期,IFX在胎盘上的运输呈指数增长;然而,ADA运输受到限制并以线性方式增加。总体而言,婴儿健康水平两组之间没有明显差异。

结论
我们的线性回归模型显示ADA可能在怀孕期间持续更长时间,因为胎盘上的运输低于IFX。这可以降低母亲的复发风险,而不会增加胎儿抗TNF暴露。因此推荐在怀孕期间可以使用ADA进行疾病的维持缓解治疗。

原始出处:
Shannon L Kanis. Et al. Anti-TNF Levels in Cord Blood at Birth are Associated with Anti-TNF Type. Journal of Crohn's and Colitis.2018.

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    2018-10-22 mfx808
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    2018-09-07 jyzxjiangqin

    婴儿出生时脐带血。

    0

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    2018-08-30 neurowu
  5. [GetPortalCommentsPageByObjectIdResponse(id=1670767, encodeId=65fa16e07674f, content=<a href='/topic/show?id=abd35513ed5' target=_blank style='color:#2F92EE;'>#抗TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55137, encryptionId=abd35513ed5, topicName=抗TNF)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7dc326754916, createdName=mfx808, createdTime=Mon Oct 22 23:46:00 CST 2018, time=2018-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1945787, encodeId=f3cf1945e871f, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sun Jul 21 06:46:00 CST 2019, time=2019-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343438, encodeId=7e883434382b, content=婴儿出生时脐带血。, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Sep 07 16:27:29 CST 2018, time=2018-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347327, encodeId=dd4d134e327a1, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355160, encodeId=9dd813551602c, content=<a href='/topic/show?id=3b47846692b' target=_blank style='color:#2F92EE;'>#脐带血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84669, encryptionId=3b47846692b, topicName=脐带血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401698, encodeId=5d3214016980f, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542399, encodeId=73951542399ea, content=<a href='/topic/show?id=82c0846654a' target=_blank style='color:#2F92EE;'>#脐带#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84665, encryptionId=82c0846654a, topicName=脐带)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06713409761, createdName=1249859em42(暂无昵称), createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341533, encodeId=836c3415339e, content=不错的文章值得拥有哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Aug 28 22:45:58 CST 2018, time=2018-08-28, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1670767, encodeId=65fa16e07674f, content=<a href='/topic/show?id=abd35513ed5' target=_blank style='color:#2F92EE;'>#抗TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55137, encryptionId=abd35513ed5, topicName=抗TNF)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7dc326754916, createdName=mfx808, createdTime=Mon Oct 22 23:46:00 CST 2018, time=2018-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1945787, encodeId=f3cf1945e871f, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sun Jul 21 06:46:00 CST 2019, time=2019-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343438, encodeId=7e883434382b, content=婴儿出生时脐带血。, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Sep 07 16:27:29 CST 2018, time=2018-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347327, encodeId=dd4d134e327a1, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355160, encodeId=9dd813551602c, content=<a href='/topic/show?id=3b47846692b' target=_blank style='color:#2F92EE;'>#脐带血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84669, encryptionId=3b47846692b, topicName=脐带血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401698, encodeId=5d3214016980f, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542399, encodeId=73951542399ea, content=<a href='/topic/show?id=82c0846654a' target=_blank style='color:#2F92EE;'>#脐带#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84665, encryptionId=82c0846654a, topicName=脐带)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06713409761, createdName=1249859em42(暂无昵称), createdTime=Thu Aug 30 09:46:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341533, encodeId=836c3415339e, content=不错的文章值得拥有哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Aug 28 22:45:58 CST 2018, time=2018-08-28, status=1, ipAttribution=)]
    2018-08-30 snowpeakxu
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    2018-08-28 1e1b8538m79(暂无匿称)

    不错的文章值得拥有哦

    0

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