PMID- 32590502
OWN - NLM
STAT- MEDLINE
DCOM- 20210903
LR  - 20210903
IS  - 1473-6322 (Electronic)
IS  - 1473-6322 (Linking)
VI  - 20
IP  - 4
DP  - 2020 Aug
TI  - Anaphylactic reactions to biological drugs.
PG  - 346-351
LID - 10.1097/ACI.0000000000000666 [doi]
AB  - 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.
FAU - Matucci, Andrea
AU  - Matucci A
AD  - Immunoallergology Unit, Careggi University Hospital, Florence.
FAU - Vultaggio, Alessandra
AU  - Vultaggio A
AD  - Immunoallergology Unit, Careggi University Hospital, Florence.
FAU - Nencini, Francesca
AU  - Nencini F
AD  - Immunoallergology Unit, Careggi University Hospital, Florence.
FAU - Maggi, Enrico
AU  - Maggi E
AD  - Translational Immunology Unit, Immunology Area, Pediatric Hospital Bambino Gesu, 
      IRCCS, Rome, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Allergy Clin Immunol
JT  - Current opinion in allergy and clinical immunology
JID - 100936359
RN  - 0 (Biological Products)
RN  - 0 (Immunoglobulin G)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Anaphylaxis/chemically induced/*diagnosis/immunology/therapy
MH  - Biological Products/administration & dosage/*adverse effects
MH  - Drug Hypersensitivity/*diagnosis/immunology/therapy
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Immunoglobulin G/immunology
MH  - Infusions, Intravenous
MH  - T-Lymphocytes, Cytotoxic/immunology
MH  - T-Lymphocytes, Regulatory/immunology
EDAT- 2020/06/27 06:00
MHDA- 2021/09/04 06:00
CRDT- 2020/06/27 06:00
PHST- 2020/06/27 06:00 [entrez]
PHST- 2020/06/27 06:00 [pubmed]
PHST- 2021/09/04 06:00 [medline]
AID - 00130832-202008000-00005 [pii]
AID - 10.1097/ACI.0000000000000666 [doi]
PST - ppublish
SO  - Curr Opin Allergy Clin Immunol. 2020 Aug;20(4):346-351. doi: 
      10.1097/ACI.0000000000000666.