{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:02:27Z","timestamp":1782298947384,"version":"3.54.5"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background and aim<\/jats:title><jats:p>Anti-TNF\u03b1 is measurable in infants exposed <jats:italic>in utero<\/jats:italic> up to 12 months of age. Data about the exposure effect on the infant\u2019s adaptive immunity are limited. We aimed to prospectively evaluate the distribution and function of T and B cells, in infants of females with inflammatory bowel disease, <jats:italic>in utero<\/jats:italic> exposed to anti-TNF\u03b1 or azathioprine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective multi-center study conducted 2014\u20132017. Anti-TNF\u03b1 levels were measured in cord blood, and at 3 and 12 months. T-cell repertoire and function were analyzed at 3 and 12 months by flow-cytometry, expression of diverse T cell receptors (TCR) and T-cell receptor excision circles (TREC) quantification assay. Serum immunoglobulins and antibodies for inactivated vaccines were measured at 12 months. Baseline clinical data were retrieved, and 2-monthly telephonic interviews were performed regarding child infections and growth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>24 pregnant females, age 30.6 (IQR 26.5\u201334.5) years were recruited, 20 with anti-TNF\u03b1 (infliximab 8, adalimumab 12), and 4 with azathioprine treatment. Cord blood anti-TNF\u03b1 was higher than maternal blood levels [4.3 (IQR 2.3\u20139.2) vs. 2.5 (IQR 1.3\u20139.7) mcg\/ml], declining at 3 and 12 months. All infants had normal number of B-cells (<jats:italic>n<\/jats:italic> = 17), adequate levels of immunoglobulins (<jats:italic>n<\/jats:italic> = 14), and protecting antibody levels to Tetanus, Diphtheria, Hemophilus influenza-B and hepatitis B (<jats:italic>n<\/jats:italic> = 17). All had normal CD4+, CD8+ T-cells, and TREC numbers. TCR repertoire was polyclonal in 18\/20 and slightly skewed in 2\/20 infants. No serious infections requiring hospitalization were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that T-cell and B-cell immunity is fully mature and immune function is normal in infants exposed <jats:italic>in utero<\/jats:italic> to anti-TNF\u03b1, as in those exposed to azathioprine. Untreated controls and large-scale studies are needed to confirm these results.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.935034","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T05:55:03Z","timestamp":1661925303000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Immune function in newborns with in-utero exposure to anti-TNF\u03b1 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