{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:05:59Z","timestamp":1785769559707,"version":"3.56.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004006","name":"Bilimsel Ara\u015ftirma Projeleri Birimi, Istanbul \u00dcniversitesi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Immunogenicity of tumor necrosis factor alpha inhibitors (TNFis) has been recognized as an important problem that may cause loss of efficacy and adverse events such as infusion reactions. TNFis are being increasingly used among patients with Beh\u00e7et syndrome (BS) and scarce data exist on this topic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to investigate the prevalence of anti-infliximab (IFX) antibodies in patients with Beh\u00e7et syndrome together with suitable controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected serum samples from 66 consecutive Beh\u00e7et syndrome patients (51 M, 15\u00a0F, mean age 37 \u00b1 9 years) who were treated with IFX. Additionally, similarly treated 27 rheumatoid arthritis, 53 ankylosing spondylitis, 25 Crohn\u2019s disease patients, and 31 healthy subjects were included as controls. Samples were collected just before an infusion, stored at \u221280\u00b0C until analysis, and serum IFX trough levels and anti-IFX antibodies were measured by ELISA. We used a cut-off value of 1 \u03bcg\/ml for serum IFX trough level, extrapolating from rheumatoid arthritis studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Anti-IFX antibodies were detected in four (6%) Beh\u00e7et syndrome, five (18.5%) rheumatoid arthritis, three (12%) Crohn\u2019s disease, and one (2%) ankylosing spondylitis patient. The median serum IFX trough level was significantly lower in patients with anti-IFX antibodies compared to those without antibodies [2.32 (IQR: 0.6\u20133.6) vs. 3.35 (IQR: 1.63\u20135.6); p = 0.019]. The serum IFX trough level was lower than the cut-off value in 6\/13 (46%) patients with anti-IFX antibodies and in 25\/158 (16%) patients without anti-IFX antibodies (p = 0.015). Among the four Beh\u00e7et syndrome patients with anti-IFX antibodies, two experienced relapses and two had infusion reactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Immunogenicity does not seem to be a frequent problem in Beh\u00e7et syndrome patients treated with IFX, but may be associated with relapses and infusion reactions, when present.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2020.618973","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T05:31:13Z","timestamp":1608615073000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Immunogenicity of Infliximab Among Patients With Beh\u00e7et Syndrome: A Controlled Study"],"prefix":"10.3389","volume":"11","author":[{"given":"Sinem Nihal","family":"Esatoglu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma Nihan","family":"Akkoc-Mustafayev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yesim","family":"Ozguler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Ozbak\u0131r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okan K.","family":"Nohut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilsen","family":"Cevirgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat","family":"Hamuryudan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Hatemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aykut Ferhat","family":"Celik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Yazici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulen","family":"Hatemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/03946320140270S102","article-title":"anti-TNF agents as therapeutic choice in immune-mediated inflammatory diseases: focus on adalimumab","volume":"27","author":"Armuzzi","year":"2014","journal-title":"Int J Immunopathol Pharmacol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s13075-018-1725-6","article-title":"Modulation of T-cell responses by anti-tumor necrosis factor treatments in rheumatoid arthritis: a review","volume":"20","author":"Davignon","year":"2018","journal-title":"Arthritis Res Ther"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/2042098611406318","article-title":"Immunogenicity and other problems associated with the use of biopharmaceuticals","volume":"2","author":"Tovey","year":"2011","journal-title":"Ther Adv Drug Saf"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex434","article-title":"Drug safety and immunogenicity of tumour necrosis factor inhibitors: the story so far","volume":"57","author":"Jani","year":"2018","journal-title":"Rheumatol (Oxford)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s40259-017-0231-8","article-title":"Immunogenicity of Biologics in Chronic Inflammatory Diseases: A Systematic Review","volume":"31","author":"Strand","year":"2017","journal-title":"BioDrugs"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.2016.1118457","article-title":"Immunogenicity of anti-TNF biologic agents in the treatment of rheumatoid arthritis","volume":"16","author":"Mok","year":"2016","journal-title":"Expert Opin Biol Ther"},{"key":"B7","unstructured":"U.S. Department of Health and Human ServicesGuidance for industry: immunogenicity assessment for therapeutic protein products2014"},{"key":"B8","unstructured":"Guideline on immunogenicity assessment of biotechnology-derived therapeutic proteins2017"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.03","article-title":"American Gastroenterological Association Institute Clinical Guidelines C. 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