Study of the immunogenicity and safety of adult acellular bacterial (dTpa) vaccine in children and adolescents with juvenile idiopathic arthritis (JIA)
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".