Impaired postnatal immune responses may result from fetal and early postnatal exposure to immunosuppressive drugs. Beyond immune suppression, there is concern that perinatal immunosuppressant exposure may exacerbate postnatal aberrant immune responses (e.g., autoimmune disease). Limited human data, especially post-pubertal data, are available that examine immune capacity after developmental immunotoxicant exposure. The multifactorial nature of hypersensitivity and autoimmune responses, in particular, will complicate elucidation of possible relationships between drug exposure during ontogeny of the human immune system and these immune-mediated diseases later in life. However, the use of potent therapeutic immunosuppressants during pregnancy has been increasing over the past several decades. It will be important that these children be followed to identify possible long-term adverse effects from such exposures during immune system establishment.
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