医学
过敏反应
免疫学
免疫原性
免疫球蛋白E
效应器
抗体
过敏反应
免疫系统
过敏
重症监护医学
作者
Andrea Matucci,Alessandra Vultaggio,Francesca Nencini,Enrico Maggi
出处
期刊:Current Opinion in Allergy and Clinical Immunology
[Ovid Technologies (Wolters Kluwer)]
日期:2020-08-01
卷期号:20 (4): 346-351
被引量:7
标识
DOI:10.1097/aci.0000000000000666
摘要
Purpose of review This review summarizes the current knowledge of the pathogenic mechanisms of biologics-induced anaphylaxis, and the diagnostic and prophylactic strategies in the management of potentially reactive patients, to improve the safety profile of biologics. Recent findings The recent knowledge on the topic highlights the involvement of both effector and regulatory mechanisms in the immune response to biological agents. In addition, the impact of biological's immunogenicity on hypersensitivity reactions has been confirmed in a wider number of studies, defining some details about the kinetics of antidrug antibodies development, specifically immunoglobulin G (IgG) and immunoglobulin E (IgE). Summary Biological agents may induce anaphylaxis, mainly through the induction of antidrug antibodies. Biologics-related infusion reactions are often clinically consistent with type I hypersensitivity, but IgG antidrug antibodies may also be involved. The immune response toward biologicals is orchestrated by both effector and regulatory T cells. In addition, nonantibody-dependent mechanisms may occur. Among clinicians persists today again a low awareness, not only of the possibility to understand the immunological mechanisms behind anaphylaxis to biologicals but also the opportunity to apply potential strategies for the management of reactive patients aimed to guarantee a safe retreatment.
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