Evidence map›Paper›PMID 40415459›Full record

ArticleHaemophilia : the official journal of the World Federation of Hemophilia2025

Longitudinal Evaluation of Immunological Biomarkers in Previously Untreated/Minimally Treated Patients With Severe and Moderately Severe Haemophilia A During Exposure to Factor VIII: Results From the HEMFIL Study.

Márcio Antônio Portugal Santana, Daniel Gonçalves Chaves, Renan Pedra Souza, Leticia Lemos Jardim, Luciana Werneck Zuccherato, Brendon Ayala Silva Santos, Mônica Hermida Cerqueira, Claudia Santos Lorenzato, Vivian Karla Brognoli Franco, Suely Meireles Rezende

Abstract read
In one paragraph

Article in Haemophilia : the official journal of the World Federation of Hemophilia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Márcio Antônio Portugal SantanaFundação Hemominas, Belo Horizonte, Minas Gerais, Brazil.ORCID https://orcid.org/0009-0001-0658-951X
Daniel Gonçalves ChavesFundação Hemominas, Belo Horizonte, Minas Gerais, Brazil.ORCID https://orcid.org/0000-0001-7431-3884
Renan Pedra SouzaInstituto of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.ORCID https://orcid.org/0000-0002-9479-4432
Leticia Lemos JardimInstituto Renè Rachou (Fiocruz Minas), Belo Horizonte, Minas Gerais, Brazil.ORCID https://orcid.org/0000-0003-3358-0075
Luciana Werneck ZuccheratoInstituto of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Brendon Ayala Silva SantosFaculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Mônica Hermida CerqueiraInstituto de Hematologia Arthur de Siqueira Calvalcanti (HEMORIO), Rio de Janeiro, Brazil.
Claudia Santos LorenzatoCentro de Hematologia e Hemoterapia do Paraná (HEMEPAR), Curitiba, Brazil.ORCID https://orcid.org/0000-0001-6662-4623
Vivian Karla Brognoli FrancoCentro de Hematologia e Hemoterapia de Santa Catarina (HEMOSC), Florianópolis, Brazil.
Suely Meireles RezendeFaculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.ORCID https://orcid.org/0000-0002-3083-7093

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHaemophilia A (HA) is an inherited bleeding disorder due to Factor VIII (FVIII) deficiency. Treatment with FVIII can activate immune mechanisms, which may lead to inhibitor development.

objectivesThis study aimed to perform a longitudinal and exploratory analysis of immunological biomarkers during replacement with FVIII concentrate and after immune tolerance induction (ITI) in patients who developed a high-responding inhibitor.

methodsBiological samples and clinical data from severe and moderately severe persons with HA (PwHA; FVIII < 0.02 IU/mL) were obtained before any or after minimal exposure (≤5 days) to FVIII (T0), at inhibitor development (INB+), at 75 exposure days (ED) without inhibitor (INB-) (T1) and at end of ITI (T2). Biomarkers were assessed at T0, T1 and T2.

resultsOne hundred patients were analysed, of whom 32 (86.5%) developed high-responding inhibitor and underwent ITI. We found no difference in the plasma concentration of the 15 immunological biomarkers at T0 or at T1 versus T2 in INB+ compared with INB-. However, at T1, PwHA INB+ who failed ITI had higher median concentration of interleukin (IL)-2 (3.50 vs. 0.85 pg/mL; q = 0.016), IL-10 (3.46 vs. 0.74 pg/mL; q = 0.035), tumour necrosis factor (TNF) (11.18 vs. 0.93 pg/mL; q = 0.016), interferon-gamma (INF-γ) (98.57 vs. 3.57 pg/mL; q = 0.035) and CCL5 (5245.11 vs. 3107.86 pg/mL; p = 0.037) compared with those who achieved complete response, respectively.

conclusionsPatients who failed ITI had higher concentration of IL-2, IL-10, TNF, INF-γ and CCL5 in comparison with complete responders, suggesting that these biomarkers could be potential predictors of ITI outcome.

Indexed as

BiomarkersFactor VIIIHemophilia AAdolescentAdultChildFemaleHumansImmune ToleranceLongitudinal StudiesMaleMiddle AgedSeverity of Illness IndexYoung AdultBiomarkersFactor VIIIFactor VIIIhaemophilia Aimmunological biomarkersinhibitorrisk factor

Identifiers

PMID40415459
PMCPMC12311890

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.