Hypersensitivity Reactions to Monoclonal Antibodies: New Approaches

AbstractPurpose of reviewAdverse reactions to monoclonal antibodies are increasing in parallel with the development of new ones. Hypersensitivity reactions related with these drugs are difficult to classify using the traditional Gell and Coombs hypersensitivity reaction classification. Monoclonal antibodies (mAbs) mainly differ from most “traditional” drugs as they are not chemical compounds, but proteins are very similar to human ones. Therefore, their metabolism, mode of action, and immunogenicity are unlike other drugs, and adverse reactions might also differ. This review focuses on the classification and underlying mechanism of the HSR induced by mAb, the available diagnostic tools, and biomarkers, as well as the therapeutic approach.Recent findings and summaryA new classification for mAb HSR based on endotype instead of phenotypic presentation has been recently proposed. Indeed, drug provocation test has been proposed in the diagnostic algorithm of mAb HSR, similarly to other “classic” drugs. Finally, we discuss the lack of knowledge about the underlying mechanism of these HSR and other unmet needs in diagnostics.
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research