Abstract
A new class of drugs, produced with the hybridoma technique, has been introduced and employed to treat many immunological diseases. This class consists of recombinant monoclonal antibodies, which can be chimeric, humanized or human. Predictably, there has been a rise in adverse hypersensitivity reactions to these therapeutic agents, whose pathogenic mechanisms are not yet well understood. Specific IgE has been demonstrated in a very few cases, and only in some of these recombinant antibodies. Skin tests are not done as a clinical routine screening. In the present article the mechanisms underlying hypersensitivity reactions to these drugs are analyzed, also in the light of the personal experience and that reported in the literature, with the aim of identifying potential risk factors and means of prevention of these reactions. For some drugs, infusion reactions may be prevented thanks to the the use of premedication. Moreover, symptoms of acute hypersensitivity during infusion can be successfully managed in the majority of cases by slowing the speed of administration. All these findings seem to confirm that the pathogenesis is not related to a true immediate (IgE-mediated) hypersensitivity in most cases. When the substitution of the drug that has triggered a hypersensitivity reaction is required, this is only possible if such an alternative drug exists (i.e., replacement of a chimeric antibody with a humanized or human antibody sharing the same target). As an alternative, desensitization protocols have been employed to induce a state of temporary tolerance to the drug in some cases, yielding successful results for infliximab and trastuzumab.
Keywords: Hypersensitivity, Monoclonal Antibodies, hybridoma technique, immunological diseases, pathogenic mechanisms, syndrome
Current Pharmaceutical Design
Title: Hypersensitivity Reactions to Last Generation Chimeric, Umanized and Human Recombinant Monoclonal Antibodies for Therapeutic Use
Volume: 14 Issue: 27
Author(s): G. Calogiuri, M. T. Ventura, L. Mason, A. Valacca, R. Buquicchio, N. Cassano and G. A. Vena
Affiliation:
Keywords: Hypersensitivity, Monoclonal Antibodies, hybridoma technique, immunological diseases, pathogenic mechanisms, syndrome
Abstract: A new class of drugs, produced with the hybridoma technique, has been introduced and employed to treat many immunological diseases. This class consists of recombinant monoclonal antibodies, which can be chimeric, humanized or human. Predictably, there has been a rise in adverse hypersensitivity reactions to these therapeutic agents, whose pathogenic mechanisms are not yet well understood. Specific IgE has been demonstrated in a very few cases, and only in some of these recombinant antibodies. Skin tests are not done as a clinical routine screening. In the present article the mechanisms underlying hypersensitivity reactions to these drugs are analyzed, also in the light of the personal experience and that reported in the literature, with the aim of identifying potential risk factors and means of prevention of these reactions. For some drugs, infusion reactions may be prevented thanks to the the use of premedication. Moreover, symptoms of acute hypersensitivity during infusion can be successfully managed in the majority of cases by slowing the speed of administration. All these findings seem to confirm that the pathogenesis is not related to a true immediate (IgE-mediated) hypersensitivity in most cases. When the substitution of the drug that has triggered a hypersensitivity reaction is required, this is only possible if such an alternative drug exists (i.e., replacement of a chimeric antibody with a humanized or human antibody sharing the same target). As an alternative, desensitization protocols have been employed to induce a state of temporary tolerance to the drug in some cases, yielding successful results for infliximab and trastuzumab.
Export Options
About this article
Cite this article as:
Calogiuri G., Ventura T. M., Mason L., Valacca A., Buquicchio R., Cassano N. and Vena A. G., Hypersensitivity Reactions to Last Generation Chimeric, Umanized and Human Recombinant Monoclonal Antibodies for Therapeutic Use, Current Pharmaceutical Design 2008; 14 (27) . https://dx.doi.org/10.2174/138161208786369786
DOI https://dx.doi.org/10.2174/138161208786369786 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Novel Drug-Induced Pulmonary Complications in Cancer Patients You Can Save Life!
Current Respiratory Medicine Reviews Anti-Inflammatory Drugs and Herbs with Special Emphasis on Herbal Medicines for Countering Inflammatory Diseases and Disorders - A Review
Recent Patents on Inflammation & Allergy Drug Discovery A Safe and Novel Desensitization Protocol with Ferric Carboxymaltose to Treat Iron Deficiency Anemia
Current Drug Safety The Complement Cascade: New Avenues in Stroke Therapy
Current Vascular Pharmacology Immunotoxicity and Immunogenicity of Biopharmaceuticals: Design Concepts and Safety Assessment
Current Drug Safety Glucose Blood Levels as a Therapeutic Target in Acute Ischaemic Stroke Setting
Current Topics in Medicinal Chemistry A Systematic Approach to Assess the Burden of Drug Interactions in Adult Kidney Transplant Patients
Current Drug Safety Irbesartan and Hydrochlorothiazide Association in the Treatment of Hypertension
Current Vascular Pharmacology Cardiovascular Pharmacogenomics
Current Pharmacogenomics and Personalized Medicine C1-Inhibitor: Structure, Functional Diversity and Therapeutic Development
Current Medicinal Chemistry The Effect of SEX/Gender on Cardiovascular Pharmacology
Current Pharmaceutical Design Serum Sickness Reaction to Rituximab with Positive Immediate Intradermal Skin Test: A Case Report
New Emirates Medical Journal The Role of Anti-Inflammatory Drugs in Respiratory Diseases - Pirfenidone, Penicillamine, Chloroquine and Chlorambucil
Current Respiratory Medicine Reviews Blood Pressure Lowering and Outcomes in type 2 Diabetes: Implications of the Blood Pressure-Lowering Arm of the Advance Trial
Current Hypertension Reviews Adverse Effects of Antihistamines on Skin Tests and Antihistamines in Pregnancy
Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents New Ways of Detecting ADRs in Neonates and Children
Current Pharmaceutical Design Antiangiogenic Function of Antithrombin is Dependent on its Conformational Variation: Implication for Other Serpins
Protein & Peptide Letters Resurgence of Herbal Antihypertensives in Management of Hypertension
Current Hypertension Reviews 3D QSAR Studies on Substituted Benzimidazole Derivatives as Angiotensin II-AT<sub>1</sub> Receptor Antagonist
Current Computer-Aided Drug Design Symptoms, Diagnosis, and Treatment of Cow's Milk Allergy
Current Pediatric Reviews