Reversal of Immunogenicity in Pediatric Inflammatory Bowel Disease Patients Receiving Anti-Tumor Necrosis Factor Medications

Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immun...

Full description

Saved in:
Bibliographic Details
Published inPediatric gastroenterology, hepatology & nutrition Vol. 21; no. 4; pp. 329 - 335
Main Authors Kang, Elise, Khalili, Ali, Splawski, Judy, Sferra, Thomas J, Moses, Jonathan
Format Journal Article
LanguageEnglish
Published Korea (South) The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 01.10.2018
대한소아소화기영양학회
Subjects
Online AccessGet full text

Cover

Loading…
Abstract Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immunogenicity include dose-intensification and/or the addition of an immunomodulator. However, there is a relative paucity of data on the efficacy of such interventions in pediatric IBD patients. Available reports have not strictly utilized homogenous mobility shift assay, which reports on anti-drug antibodies even in the presence of detectable drug, whereas prior studies have been confounded by the use of drug sensitive assays. We report four pediatric inflammatory bowel disease patients with successful reversal of immunogenicity on an anti-TNF agent using dose intensification and/or addition of an immunomodulator.
AbstractList Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immunogenicity include dose-intensification and/or the addition of an immunomodulator. However, there is a relative paucity of data on the efficacy of such interventions in pediatric IBD patients. Available reports have not strictly utilized homogenous mobility shift assay, which reports on anti-drug antibodies even in the presence of detectable drug, whereas prior studies have been confounded by the use of drug sensitive assays. We report four pediatric inflammatory bowel disease patients with successful reversal of immunogenicity on an anti-TNF agent using dose intensification and/or addition of an immunomodulator. KCI Citation Count: 0
Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immunogenicity include dose-intensification and/or the addition of an immunomodulator. However, there is a relative paucity of data on the efficacy of such interventions in pediatric IBD patients. Available reports have not strictly utilized homogenous mobility shift assay, which reports on anti-drug antibodies even in the presence of detectable drug, whereas prior studies have been confounded by the use of drug sensitive assays. We report four pediatric inflammatory bowel disease patients with successful reversal of immunogenicity on an anti-TNF agent using dose intensification and/or addition of an immunomodulator.
Author Kang, Elise
Sferra, Thomas J
Splawski, Judy
Moses, Jonathan
Khalili, Ali
AuthorAffiliation Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
AuthorAffiliation_xml – name: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
Author_xml – sequence: 1
  givenname: Elise
  surname: Kang
  fullname: Kang, Elise
  organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
– sequence: 2
  givenname: Ali
  surname: Khalili
  fullname: Khalili, Ali
  organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
– sequence: 3
  givenname: Judy
  surname: Splawski
  fullname: Splawski, Judy
  organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
– sequence: 4
  givenname: Thomas J
  surname: Sferra
  fullname: Sferra, Thomas J
  organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
– sequence: 5
  givenname: Jonathan
  surname: Moses
  fullname: Moses, Jonathan
  organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30345247$$D View this record in MEDLINE/PubMed
https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002393576$$DAccess content in National Research Foundation of Korea (NRF)
BookMark eNpVkU1vEzEQhi1URD_oH-CAfOWwi79213tBCoVCpAJVFM7WxDubmu7akb0JisSPr9PQCuYyI80878zoPScnPngk5A1nZSWEfL9Z3_lSMK5LwUtVStG-IGe5oQqtFTt5qmtVn5LLlH6xHA2XkvNX5FQyqSqhmjPyZ4E7jAkGGno6H8etD2v0zrppT52nt9g5mKKzdO77AcYRphD39GP4jQP95BJCQnoLk0M_JbpAi27n_JrO_OSK5XYMkX5HG0NyiV6DzTD9liVtJoJPr8nLHoaEl3_zBfl5_Xl59bW4-fFlfjW7Kaxiciok6B4w16C4Zp2odNPWlVVKM9WvgGsOSvOmVtB3uGpq3VQSLQNYQdtWXScvyLujro-9ubfOBHCPeR3MfTSzxXJuZNOwWrZ59sNxdrNdjdjZ_FiEwWyiGyHuH8n_O97dZZ2dqbkW-aIsII4Ch7dTxP6Z5cwcrDMH68zBOiO4USZbl6G3_259Rp6Mkg9CoJqA
CitedBy_id crossref_primary_10_1002_jpn3_12041
crossref_primary_10_1016_j_molmed_2021_08_003
crossref_primary_10_3389_fimmu_2020_01148
Cites_doi 10.1016/S0140-6736(02)08512-4
10.1136/gutjnl-2014-307883
10.1002/ibd.20899
10.1053/j.gastro.2013.10.052
10.1056/NEJMoa050516
10.1016/j.jim.2012.06.002
10.1038/ajg.2012.363
10.1007/s40265-017-0693-5
10.1038/ajg.2008.88
10.1111/j.1365-2036.2011.04599.x
10.1016/S0889-8553(01)00017-6
10.1056/NEJMoa020888
10.1136/gutjnl-2014-307882
10.1056/NEJMoa0904492
10.1097/MIB.0000000000001100
10.1038/ajg.2013.12
10.1053/j.gastro.2015.02.031
10.1097/MPG.0000000000001029
10.1053/j.gastro.2017.07.032
ContentType Journal Article
Copyright Copyright © 2018 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2018 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Copyright_xml – notice: Copyright © 2018 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2018 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
DBID NPM
AAYXX
CITATION
5PM
ACYCR
DOI 10.5223/pghn.2018.21.4.329
DatabaseName PubMed
CrossRef
PubMed Central (Full Participant titles)
Korean Citation Index
DatabaseTitle PubMed
CrossRef
DatabaseTitleList
PubMed

Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
DeliveryMethod fulltext_linktorsrc
EISSN 2234-8840
EndPage 335
ExternalDocumentID oai_kci_go_kr_ARTI_3770639
10_5223_pghn_2018_21_4_329
30345247
Genre Case Reports
GroupedDBID .UV
5-W
8JR
8XY
9ZL
ABDBF
ACYCR
ADRAZ
ALMA_UNASSIGNED_HOLDINGS
DIK
EF.
HYE
KQ8
KVFHK
M48
NPM
OK1
PGMZT
RPM
AAYXX
CITATION
5PM
ID FETCH-LOGICAL-c403t-3a8faec40a4180d2587965c44804fba181a481764afdeb768753ec0aaba995dd3
IEDL.DBID RPM
ISSN 2234-8646
IngestDate Tue Nov 21 21:41:06 EST 2023
Tue Sep 17 20:59:47 EDT 2024
Fri Aug 23 00:30:13 EDT 2024
Sat Sep 28 08:37:00 EDT 2024
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 4
Keywords Antibodies
Child
Biological products
Language English
License This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c403t-3a8faec40a4180d2587965c44804fba181a481764afdeb768753ec0aaba995dd3
OpenAccessLink https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182480/
PMID 30345247
PageCount 7
ParticipantIDs nrf_kci_oai_kci_go_kr_ARTI_3770639
pubmedcentral_primary_oai_pubmedcentral_nih_gov_6182480
crossref_primary_10_5223_pghn_2018_21_4_329
pubmed_primary_30345247
PublicationCentury 2000
PublicationDate 2018-10-01
PublicationDateYYYYMMDD 2018-10-01
PublicationDate_xml – month: 10
  year: 2018
  text: 2018-10-01
  day: 01
PublicationDecade 2010
PublicationPlace Korea (South)
PublicationPlace_xml – name: Korea (South)
PublicationTitle Pediatric gastroenterology, hepatology & nutrition
PublicationTitleAlternate Pediatr Gastroenterol Hepatol Nutr
PublicationYear 2018
Publisher The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
대한소아소화기영양학회
Publisher_xml – name: The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
– name: 대한소아소화기영양학회
References Gisbert (10.5223/pghn.2018.21.4.329_ref10) 2009; 104
Vande Casteele (10.5223/pghn.2018.21.4.329_ref16) 2015; 64
Baert (10.5223/pghn.2018.21.4.329_ref11) 2016; 65
Vande Casteele (10.5223/pghn.2018.21.4.329_ref18) 2015; 148
Baert (10.5223/pghn.2018.21.4.329_ref6) 2003; 348
Peyrin-Biroulet (10.5223/pghn.2018.21.4.329_ref2) 2011; 33
Colombel (10.5223/pghn.2018.21.4.329_ref14) 2010; 362
Wang (10.5223/pghn.2018.21.4.329_ref9) 2012; 382
Sandborn (10.5223/pghn.2018.21.4.329_ref19) 2017; 23
Hanauer (10.5223/pghn.2018.21.4.329_ref3) 2002; 359
Minar (10.5223/pghn.2018.21.4.329_ref8) 2016; 62
Rutgeerts (10.5223/pghn.2018.21.4.329_ref4) 2005; 353
Cassinotti (10.5223/pghn.2018.21.4.329_ref5) 2009; 15
Nanda (10.5223/pghn.2018.21.4.329_ref12) 2013; 108
Vande Casteele (10.5223/pghn.2018.21.4.329_ref13) 2013; 108
Panaccione (10.5223/pghn.2018.21.4.329_ref15) 2014; 146
Hindryckx (10.5223/pghn.2018.21.4.329_ref7) 2017; 77
Cuffari (10.5223/pghn.2018.21.4.329_ref1) 2002; 31
Feuerstein (10.5223/pghn.2018.21.4.329_ref17) 2017; 153
References_xml – volume: 359
  start-page: 1541
  year: 2002
  ident: 10.5223/pghn.2018.21.4.329_ref3
  publication-title: Lancet
  doi: 10.1016/S0140-6736(02)08512-4
  contributor:
    fullname: Hanauer
– volume: 64
  start-page: 1539
  year: 2015
  ident: 10.5223/pghn.2018.21.4.329_ref16
  publication-title: Gut
  doi: 10.1136/gutjnl-2014-307883
  contributor:
    fullname: Vande Casteele
– volume: 15
  start-page: 1264
  year: 2009
  ident: 10.5223/pghn.2018.21.4.329_ref5
  publication-title: Inflamm Bowel Dis
  doi: 10.1002/ibd.20899
  contributor:
    fullname: Cassinotti
– volume: 146
  start-page: 392
  year: 2014
  ident: 10.5223/pghn.2018.21.4.329_ref15
  publication-title: Gastroenterology
  doi: 10.1053/j.gastro.2013.10.052
  contributor:
    fullname: Panaccione
– volume: 353
  start-page: 2462
  year: 2005
  ident: 10.5223/pghn.2018.21.4.329_ref4
  publication-title: N Engl J Med
  doi: 10.1056/NEJMoa050516
  contributor:
    fullname: Rutgeerts
– volume: 382
  start-page: 177
  year: 2012
  ident: 10.5223/pghn.2018.21.4.329_ref9
  publication-title: J Immunol Methods
  doi: 10.1016/j.jim.2012.06.002
  contributor:
    fullname: Wang
– volume: 108
  start-page: 40
  year: 2013
  ident: 10.5223/pghn.2018.21.4.329_ref12
  publication-title: Am J Gastroenterol
  doi: 10.1038/ajg.2012.363
  contributor:
    fullname: Nanda
– volume: 77
  start-page: 363
  year: 2017
  ident: 10.5223/pghn.2018.21.4.329_ref7
  publication-title: Drugs
  doi: 10.1007/s40265-017-0693-5
  contributor:
    fullname: Hindryckx
– volume: 104
  start-page: 760
  year: 2009
  ident: 10.5223/pghn.2018.21.4.329_ref10
  publication-title: Am J Gastroenterol
  doi: 10.1038/ajg.2008.88
  contributor:
    fullname: Gisbert
– volume: 33
  start-page: 870
  year: 2011
  ident: 10.5223/pghn.2018.21.4.329_ref2
  publication-title: Aliment Pharmacol Ther
  doi: 10.1111/j.1365-2036.2011.04599.x
  contributor:
    fullname: Peyrin-Biroulet
– volume: 31
  start-page: 275
  year: 2002
  ident: 10.5223/pghn.2018.21.4.329_ref1
  publication-title: Gastroenterol Clin North Am
  doi: 10.1016/S0889-8553(01)00017-6
  contributor:
    fullname: Cuffari
– volume: 348
  start-page: 601
  year: 2003
  ident: 10.5223/pghn.2018.21.4.329_ref6
  publication-title: N Engl J Med
  doi: 10.1056/NEJMoa020888
  contributor:
    fullname: Baert
– volume: 65
  start-page: 1126
  year: 2016
  ident: 10.5223/pghn.2018.21.4.329_ref11
  publication-title: Gut
  doi: 10.1136/gutjnl-2014-307882
  contributor:
    fullname: Baert
– volume: 362
  start-page: 1383
  year: 2010
  ident: 10.5223/pghn.2018.21.4.329_ref14
  publication-title: N Engl J Med
  doi: 10.1056/NEJMoa0904492
  contributor:
    fullname: Colombel
– volume: 23
  start-page: 1047
  year: 2017
  ident: 10.5223/pghn.2018.21.4.329_ref19
  publication-title: Inflamm Bowel Dis
  doi: 10.1097/MIB.0000000000001100
  contributor:
    fullname: Sandborn
– volume: 108
  start-page: 962
  year: 2013
  ident: 10.5223/pghn.2018.21.4.329_ref13
  publication-title: Am J Gastroenterol
  doi: 10.1038/ajg.2013.12
  contributor:
    fullname: Vande Casteele
– volume: 148
  start-page: 1320
  year: 2015
  ident: 10.5223/pghn.2018.21.4.329_ref18
  publication-title: Gastroenterology
  doi: 10.1053/j.gastro.2015.02.031
  contributor:
    fullname: Vande Casteele
– volume: 62
  start-page: 715
  year: 2016
  ident: 10.5223/pghn.2018.21.4.329_ref8
  publication-title: J Pediatr Gastroenterol Nutr
  doi: 10.1097/MPG.0000000000001029
  contributor:
    fullname: Minar
– volume: 153
  start-page: 827
  year: 2017
  ident: 10.5223/pghn.2018.21.4.329_ref17
  publication-title: Gastroenterology
  doi: 10.1053/j.gastro.2017.07.032
  contributor:
    fullname: Feuerstein
SSID ssj0000713311
Score 2.1366153
Snippet Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain...
SourceID nrf
pubmedcentral
crossref
pubmed
SourceType Open Website
Open Access Repository
Aggregation Database
Index Database
StartPage 329
SubjectTerms Case Report
소아과학
SummonAdditionalLinks – databaseName: Scholars Portal Journals: Open Access
  dbid: M48
  link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LS8QwEB58gHgRxdf6Iog3aW2bNG1P4mtxBUXEBW8hbVO3qK12V1TwxzvT7i67oBdPLW0TmnzT5vuSyQzAgRtL1B2IgMxo6sbXoRXLTFvcN1w7kROa2jfn-kZedsXVg_8wA6N0R8MO7P8q7SifVLd6tj_fvo7xg0f-aiN74Eevjz2KZOqGtufawuZeNAvznuCCLP56SPfrPzMpsjolLxYTViiFbPbR_FHNIizgH174HiVfmRi2Zosqmxixpr0pJ4an9jIsDXklO2kMYQVmTLEK33eGvC7wepmxDu0EKdFe8gSZN8sLNk7TwTpFhpbxUq-4s9Pywzyz82blht02gVf7DAmmyWn6gZ0Ug9y6f38pK3Zj6H3zPmvXeXtYs-5T2_IadNsX92eX1jDdgpUIhw8srsNMGzzXwg2dFBEMIuknqN8ckcUaqYAWoRtIobPUxChTUOmYxNE61lHkpylfh7miLMwmsDTV3IlSJI9eLJAzoMjzUCpxmcRIH4zbgsNRb6rXJqqGQjVCMCiCQREMynOVUAhDC_axw9VTkisKhk3Hx1I9VQopf0fxICCa1YKNBoZxhSPoWhBMATR-gCqbvlPkvTrCtkTVhc3e-nfJbVikJjRefzswN6jezS6yl0G8V5vkDzGG7gk
  priority: 102
  providerName: Scholars Portal
Title Reversal of Immunogenicity in Pediatric Inflammatory Bowel Disease Patients Receiving Anti-Tumor Necrosis Factor Medications
URI https://www.ncbi.nlm.nih.gov/pubmed/30345247
https://pubmed.ncbi.nlm.nih.gov/PMC6182480
https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002393576
Volume 21
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
ispartofPNX Pediatric Gastroenterology, 2018, Hepatology & Nutrition, 21(4), , pp.329-335
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1NT-MwEB1RTntBoP2gwCIL7W2VNIkdxzmy7FZ0pSK0AombZScORFCnKkV72R-_M05btVdOifIlx2_kec8ezwB8S61E3YEIyIambnKjIisbE_HccZOUiXIhNmd6I6_vxe-H_GEP8vVemBC0X9k29i-z2LdPIbZyPqtG6zix0e30SiIpFioZDWBQcL4l0cPwS7Ir1N1FzyciJYXsN8sg0-Cj-eMTZT1NVZylsYh5RmlDcRgXeUYVVrZ808Avmi23tBsyueWDxodwsCKP7LJv5BHsOf8R_v1xFFqB17uGTWi7R4dG0VZIr1nr2aYWB5v4BuGfhWV19qP7617Yz355ht322VVfGbJI19IcA7v0yza6e5t1C3bjqL3tKxuH4jysX9wJBvsJ7se_7q6uo1VNhagSCV9G3KjGODw3IlVJjTAVpcwrFGmJaKxBf2-ESgspTFM7i1oE5YyrEmOsKcu8rvln2Pedd8fA6trwpKyRIWZWIDFAJZehHuKyssgRXDqE7-ve1PM-dYZGyUEwaIJBEww6S7XQCMMQLrDD9XPVasp4TcfHTj8vNPL6ieZFQVxqCF96GDYfXEM3hGIHoM0D9LHdO2hVIY32yopO3v3mKXygX-hD-85gf7l4c1-RoiztOQymQp0Hw_wPsPvmug
link.rule.ids 230,315,733,786,790,891,2236,24346,27957,27958,53827,53829
linkProvider National Library of Medicine
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3Pb9MwFLa2cYALA_FjZQMsxA0lTWLHSY7boGphrSbUod0s23G2qKtTdamQ0P74PdtN1XKDU6I4ieJ8z_b32c_vIfQ5lgx0ByDAKjt1k4o8kKwSAUk1EVER5dr55ownbHhFv1-n13so7fbCOKd9JevQ3M1DU98638rFXPU7P7H-5ficASmmedTfR0-gvSbZlkh3HbAVXi7zLox9NMgZZX67DHAN0l_c3Nq4p3EeJnFIQ5LYwKHQkdM0sTlWtkanfbOstgamXafJrVFocIh-dd_vnU9m4aqVofrzV2jHf67gC_R8zUvxqS9-ifa0eYUefmrrtQHXmwqP7E6SBuytVsDccW3wJs0HHpkKLGvuVuzxWfNb3-GvfuUHX_rArfcYCKqu7fQFPjVtHUxX82aJJ9r-iPoeD1zeH-zXjVxbeI2uBt-m58Ngna4hUDQibUBEXgkN54LGeVSCBWQFSxXov4hWUgCVEDSPM0ZFVWoJMgeUklaREFIURVqW5A06MI3RRwiXpSBRUQL5TCQFzgEiMQGpRZiSQD903ENfOpj4wkfl4KBmLL7c4sstvjyJOeWAbw99AiT5TNXcBtO2x5uGz5YcJMOIkyyzNK2H3np8Ny_sbKKHsh3kNzfYl-2WAJ4uQvcav3f__eRH9HQ4HV_wi9HkxzF6ZqvjPQhP0EG7XOn3wIRa-cHZ_SM2fwfk
linkToPdf http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1ba9swFBZrB2Mvu7BbdhVjb8NXybL92LULzbaGMFooexGSLLUmjRxSh8HYj9-RlARnj32ysWWB_B1J3ycdnYPQp0wy0B2AADNu6aYQVSSZEREpNBFpnVba--acTdnpBf12WVwOUn15p30l29jeLGLbXnvfyuVCJVs_sWR2dsyAFNMqTZaNSQ7QfeizeT0Q6n4QduLLZ9-F-Y9GFaMsHJkBvkGS5dW1i32aVXGexTQmuQseCoM5LXKXZ2UwQx3YlRlMTvuOk4OZaPwY_dq2ITigzON1L2P157_wjndq5BP0aMNP8VEo8hTd0_YZ-vtTO-8NeN4ZPHEnSjqwu1YBg8etxbt0H3hiDVjYwu_c4y_db32DT8IOEJ6FAK63GIiqbt0yBj6yfRudrxfdCk-1-xntLR77_D847B_5PvEcXYy_nh-fRpu0DZGiKekjIiojNNwLmlVpA5ZQ1qxQoANTaqQASiFolZWMCtNoCXIHFJNWqRBS1HXRNOQFOrSd1a8QbhpB0roBEppLCtwDxGIOkoswJYGG6GyEPm-h4ssQnYODqnEYc4cxdxjzPOOUA8Yj9BHQ5HPVchdU212vOj5fcZAOE07K0tG1EXoZMN5VuLWLESr30N8VcJXtvwFMfaTuDYav7_zlB_RgdjLmPybT72_QQ9ea4Ej4Fh32q7V-B4Sol--96f8DeUoKZA
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Reversal+of+Immunogenicity+in+Pediatric+Inflammatory+Bowel+Disease+Patients+Receiving+Anti-Tumor+Necrosis+Factor+Medications&rft.jtitle=Pediatric+gastroenterology%2C+hepatology+%26+nutrition&rft.au=Kang%2C+Elise&rft.au=Khalili%2C+Ali&rft.au=Splawski%2C+Judy&rft.au=Sferra%2C+Thomas+J.&rft.date=2018-10-01&rft.pub=The+Korean+Society+of+Pediatric+Gastroenterology%2C+Hepatology+and+Nutrition&rft.issn=2234-8646&rft.eissn=2234-8840&rft.volume=21&rft.issue=4&rft.spage=329&rft.epage=335&rft_id=info:doi/10.5223%2Fpghn.2018.21.4.329&rft_id=info%3Apmid%2F30345247&rft.externalDBID=PMC6182480
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2234-8646&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2234-8646&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2234-8646&client=summon