炎症性肠病患者免疫抑制剂和生物制剂治疗对疫苗接种的影响

Effects of immunosuppressive and biological agents on vaccination in patients with inflammatory bowel disease

炎症性肠病(inflammatory bowel disease,IBD)患者接受免疫抑制治疗的概率增加,其中包括激素、免疫抑制、生物制剂、小分子药物中的一种或多种。这些治疗抑制或调节了免疫系统,从而增加了发生某些感染的风险。通过接种疫苗可以有效预防多种传染性疾病,然而,使用免疫抑制类药物治疗的IBD患者与正常人群间由于药物的使用可能存在疫苗接种的一些特殊问题。本文重点关注使用免疫抑制类药物治疗的IBD患者疫苗接种的难点,对疫苗制作的工艺、整体认识以及特殊问题做出总结,并强调消化专科医师、感染病学专家、社区疫苗接种医师共同协作对于疫苗接种的重要性。

Patients with inflammatory bowel disease(IBD)are more likely to receive immunosuppressive therapy,including one or more medications of hormone,immunosuppressives,biologics and small molecules.These medications inhibit or regulate the immune system,thereby increasing the risk of infection.The vaccines can effectively prevent a variety of infectious diseases.However,there may be some special issues of vaccination in IBD patients treated with immunosuppressives and normal persons due to the use of drugs.This review focused on the difficulties of vaccines in IBD patients treated with immunosuppressives,summarized the process,understanding and special problems of vaccine,and emphasized the importance of cooperation among gastroenterologists,infectious experts and community doctors for vaccination.