Navigation Links
Immunosuppressant further linked to birth defects
Date:2/6/2008

A new study documents malformations seen in an infant born to a kidney transplant recipient who had taken mycophenolate mofetil (MMF), a widely used immunosuppressant available commercially as Cellcept. The findings suggest a specific birth defect pattern particular to this drug, reinforcing its potential to harm to the fetus. The study was published in the January 2008 issue of the American Journal of Medical Genetics, available online via Wiley InterScience at http://www3.interscience.wiley.com/journal/117869018/issue.

Approximately 14,000 births to organ transplant recipients, primarily kidney transplant patients, have been reported worldwide. Although pregnancy was initially ill-advised for these women, the American Society of Transplantation concluded in 2003 that pregnancy is usually safe following the first year of a transplant, provided that organ rejection or other complications have not occurred. The fetal side-effects of several immunosuppressant drugs have been studied, though not for widely used newer medications, such as (MMF).

The use of immunosuppressant drugs is a required, life-long treatment for solid organ transplant recipients. They are used to prevent, inhibit or reduce the natural reaction of the immune system against foreign tissues. However, these drugs have important side effects that sometimes preclude their use. The FDA divides immunosuppressants into four categories (A, B, C and D) regarding toxicity to the fetus. MMF has recently been upgraded to class D during pregnancy, meaning that its use is precluded for the high risk of fetal malformations. Immunosupressants are also given to women with severe autoimmune diseases, such as generalized lupus. In fact, 3 out of 10 babies described in the literature regarding these defects had mothers on MMF because of lupus nephritis.

Led by Dr. Antonio Perez-Aytes and Dr. Maximo Vento of the Newborn Research Unit at the Hospital Universitario Materno-Infantil La Fe, in Valencia, Spain, the study describes a 25-year-old Spanish woman who had undergone two kidney transplants. Following the second transplant she took the immunosuppressant drugs tacrolimus and MMF. Two years later she became pregnant and MMF was discontinued at 10 weeks gestation, while tacrolimus, one of the drugs that has been studied in pregnant women, was maintained. She delivered a female infant who had cleft lip and palate, as well as defects of the jaw, eyes and ears, including no external ear canals. At nine months her child was developing normally, although she needed hearing aids.

The pattern of defects seen in this infant is very similar to previous reports of birth defects in infants who were exposed to MMF in utero. The study describes these infants, noting that the pattern of cleft lip/palate and ear malformations was seen in every case but one. Although defects of the eye had not been seen in humans before, studies in rats and rabbits have shown ocular malformations following exposure to MMF. The authors suggest that the pattern of defects seen with MMF establishes a possible link between use of this drug during pregnancy and a specific malformation pattern in structures derived from the frontal-nasal prominence (which develops into the forehead, nose, upper lip and palate) and the first pharyngeal arch (which develops into the jaw and ear).

It should be noted, however, that if a transplant recipient is of fertile age, she can give birth to a healthy baby. The patient needs to be adequately counseled, and withdraw from immunosuppressants that may be deleterious to the baby within sufficient of becoming pregnant to avoid any interference during the first 12 weeks of gestation, says Dr. Maximo Vento, co-author of the study.


'/>"/>

Contact: Sean Wagner
swagner@bos.blackwellpublishing.com
781-388-8550
Blackwell Publishing Ltd.
Source:Eurekalert

Related biology news :

1. Further development of Water Framework Directive necessary
2. Further breakthroughs for breast cancer patients
3. Worlds largest investor coalition seeks further disclosure on climate change and shareholder value
4. Risk of common vaginal infection linked to preterm birth appears higher for blacks
5. Scientists show that mitochondrial DNA variants are linked to risk factors for type 2 diabetes
6. Protein chatter linked to cancer activation
7. Western diet linked to increased risk of colon cancer recurrence
8. Sugary drinks, not fruit juice, may be linked to insulin
9. Brains timing linked with timescales of the natural visual world
10. Low vitamin D during pregnancy linked to pre-eclampsia
11. Genetic variant linked to odor perception
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/3/2016)... 3, 2016 ... the "Emotion Detection and Recognition Market ... Others), Software Tools (Facial Expression, Voice Recognition ... Regions - Global forecast to 2020" ... http://www.researchandmarkets.com/research/d8zjcd/emotion_detection ) has announced the addition ...
(Date:2/2/2016)... 2, 2016 This BCC Research report ... by reviewing the recent advances in high throughput ... the field forward. Includes forecast through 2019. ... challenges and opportunities that exist in the bioinformatic ... developers, as well as IT and bioinformatics service ...
(Date:2/2/2016)... Technology Enhancements Accelerate Growth of X-ray Imaging ... and computed radiography markets in Thailand ... Indonesia (TIM). It provides an in-depth analysis ... as regional market drivers and restraints. The study offers ... market attractiveness, both for digital and computed radiography. Market ...
Breaking Biology News(10 mins):
(Date:2/3/2016)... Feb. 3, 2016 New Jersey Health Foundation ... $1 million for researchers in New ... research that demonstrates exciting potential.   ... for the New Jersey Health Foundation Research Grant ... these educational institutions— Princeton University, Rutgers University, Rowan ...
(Date:2/3/2016)... , ... February 03, 2016 , ... ... Linux and Unix visualization solutions today announced the addition of a powerful “Session ... users to see the current state of the remote Linux desktop or other ...
(Date:2/3/2016)... , Feb. 3, 2016  Today, Symphony Technology Group ... AlphaImpactRx , a leading provider of primary research and ... IMS Health , a global information and technology ... capabilities and technologies will be integrated into IMS Health ... primary market research capabilities. ...
(Date:2/3/2016)... ... February 03, 2016 , ... Marktech Optoelectronics, ... and wafers, and InP epi wafers based in Latham, New York, offers a ... transistors, and Avalanche photodiodes–to Si and InGaAs PIN photodiodes. But it is Marktech's ...
Breaking Biology Technology: