Abstracts (complete list) - Wissenschaft Online

Stephan Borte, Uwe Gerd Liebert, Michael Borte, Ulrich Sack
Long-term cell-mediated immunity following vaccination with
live, attenuated measles-mumps-rubella-vaccine in children
with juvenile idiopathic arthritis under treatment with lowdose
Methotrexate and/or tumour necrosis factor α receptor
antagonist
Juvenile idiopathic arthritis (JIA) represents a heterogeneous group of disorders
characterized by chronic inflammatory arthritis and turns out to be the commonest
rheumatic disease seen in childhood worldwide. The multidisciplinary management of
JIA is founded on anti-inflammatory and immunomodulating drugs. However, infection
is one of the leading causes of morbidity and mortality in JIA. The risks of serious
adverse events following vaccination and the immunogenicity of vaccines at all have
been a matter of controversy and there is some reluctance to vaccination that need to
be enlightened. We intended to display the course of humoral and cell-mediated
immunity to measles-mumps-rubella-vaccination (MMR) in healthy children and
adolescents and to evaluate potential influences of low-dose Methotrexate therapy and
Etanercept treatment in JIA on success of immunisation and maintenance of long-term
immunity. Therefore, production of IFNγ by T memory cells upon in vitro stimulation
with measles, mumps and rubella antigens and seroprevalence of virus-specific IgG
antibodies were investigated in PBMC and plasma from 16 healthy children and 16
children with JIA, being treated with low-dose Methotrexate or in combination with
Etanercept. Our results indicate that MMR-vaccination induced immunity in childhood is
characterized by steady decline of humoral immunity and development of long-term cellmediated
immunity. Low-dose MTX therapy following completed MMR-vaccination was
proved not to hamper Th1-like cell-mediated immunity in vitro. Furthermore, neither
low-dose MTX nor Etanercept treatment during the course of vaccination showed to
markedly interfere with intended outcome of immunisation and generation of long-term
cell-mediated immunity to MMR. No cases of serious adverse events following MMRvaccination
were observed. In conclusion, these results argue for MMR-vaccination in
children with JIA using live, attenuated vaccines to ensure protection from infection and
to prevent morbidity and mortality related to this diseases.