Immunological risk factors for infection after immunosuppressive and biologic therapies

Abstract

Immunosuppressive and biologic therapies are costly and can involve a considerable risk of infection. Noninvasive diagnostic tools for early prediction of infection before and after administration of these therapies are of major interest. Serial longitudinal immune monitoring would provide data on immunocompetence and complement clinical follow-up protocols. Biomarkers of immune response may be useful to identify patients at risk of developing infection and who could be candidates for immunosuppressant dose reduction. This article focuses on the potential use of biomarkers of immune response to predict development of infection after immunosuppressive and biologic therapies in selected settings of autoimmune disease (rituximab for treatment of rheumatoid arthritis) and solid organ transplantation.

Keywords::

• biologic therapy
• biomarkers
• cellular immunity
• humoral immunity
• immune monitoring
• immunosuppressive therapy
• infection
• risk factors

Financial & competing interests disclosure

This study was supported by research funding from the Fondo de Investigacion Sanitaria, Madrid, Spain, Projects FIS 05/0839 and FIS 081430 to Javier Carbone. Elizabeth Sarmiento has an educational grant of Grifols International, Barcelona, Spain and of the European Molecular Biology Organization. Nadia del Pozo has a grant of the Fundacion para la Investigacion Biomedica del Hospital Gregorio Marañon, Madrid, Spain. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.