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Adverse side-effects of biological agents: Hypersensitivity reactions

Neželjeni efekti bioloških lekova - reakcije preosetljivosti

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2014
2272.pdf (256.1Kb)
Authors
Stojić-Vukanić, Zorica
Arsenović-Ranin, Nevena
Antić-Stanković, Jelena
Milenković, Marina
Article (Published version)
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Abstract
Clinical use of various biological agents (protein-based products derived from biological sources, such as bacteria, fungi or mammalian cells) have greatly improved the treatment of a wide variety of diseases in humans. Nevertheless, a variety of their adverse reactions have been observed. These adverse effects have been clasified in five types (α, β, γ, δ and ε). Type β adverse effect involves hypersensitivity reactions linked to the immunogenicity of biological agents. It is worth emphasizing that biological agents irrespective whether they contain xenoantigens may lead to development of anti-drug antibodies. Several drug-, patients-, diseaseand treatment-related factors contribute to immunogenicity of biological agents. Anti-drug antibodies can influence either the efficacy of biological agent or induce hypersensitivity reactions. One of them is immediate infusion reaction, which occurs during or within one hour after biological agent infusion. This reaction may cause mild to severe... clinical manifestations. Involvement of IgE- and non-IgE isotypes in hypersentitivity reactions are confirmed by novel methods for detecting anti-drug antibodies. This manuscript summarizes the current knowledge on factors influencing immunogenicity to biological agents, and points to the mechanisms underlying the drug-induced hypersensitivity reactions.

Više od dve decenije biološki lekovi (proteini dobijeni iz bioloških izvora, kao što su bakterije, gljive ili ćelije sisara) koriste se u terapiji različitih autoimunskih/ inflamatornih bolesti i tumora kod ljudi. Primena ovih lekova praćena je pojavom novih neželjenih efekata koji se mogu svrstati u pet različitih grupa koje se obeležavaju slovima grčkog alfabeta (od α do ε). Reakcije preosetljivosti koje se vezuju za imunogenost bioloških lekova su klasifikovane kao reakcije iz grupe tip β. U praksi, svi proteini koji se koriste kao biološki lekovi, pokreću imunski odgovor, a kao rezultat nastaju anti-lek antitela. Brojni faktori koji su vezani za sam lek, pacijenta ili način davanja leka mogu da utiču na imunogenost nekog biološkog leka. Anti-lek antitela mogu da se vežu za lek i smanje njegovu efikasnost ili da izazovu reakcije preosetljivosti (uglavnom tip I, ređe tip III). Infuzijska reakcija, koja se javlja već u toku davanja infuzije leka ili u okviru jednog sata od njenog zavr...šetka, jedna je od najčešćih reakcija preosetljivosti na biološke lekove. U ovom radu opisani su faktori koji mogu da utiču na imunogenost bioloških lekova i patogenetski mehanizmi reakcija preosetljivosti na biološke lekove.

Keywords:
immunogenicity / biological agents / anti-drug antibodies / adverse side-effects / monoclonal antibodies / imunogenost / biološki lekovi / anti-lek antitela / neželjeni efekti / monoklonska antitela
Source:
Arhiv za farmaciju, 2014, 64, 6, 457-472
Publisher:
  • Savez farmaceutskih udruženja Srbije, Beograd

DOI: 10.5937/arhfarm1406457S

ISSN: 0004-1963

Scopus: 2-s2.0-84943738826
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URI
http://farfar.pharmacy.bg.ac.rs/handle/123456789/2274
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