Allergy Unit, Department of Dermatology, University Hospital Basel, Switzerland.
J Dtsch Dermatol Ges. 2010 Jun;8(6):411-26. doi: 10.1111/j.1610-0387.2010.07339.x. Epub 2010 Feb 3.
The use of biologics has rapidly expanded since the introduction of the first diagnostic antibodies; they are now widely employed in oncology, autoimmune disorders, inflammatory diseases and transplantation medicine. Their widespread use has resulted in an increase in adverse drug reactions. Adverse effects result from both direct pharmacological actions and immunological actions, as well as through induction of a specific immune response. The nomenclature, particularly of the monoclonal antibodies, identifies the target structure and organ as well as the species of origin, which then helps predict their effects and antigenic properties. Depending on the extent of foreign protein, anti-allotypic or anti-idiotypic antibodies with or without neutralizing properties may be induced. Adverse drug reactions from biologics often depend on the target and may be explained by activation or inhibition of particular cytokine pathways. Adverse drug reactions are classified by their pathomechanism, which enhances understanding of the pathogenesis and facilitates both allergologic diagnostic measures and planning of premedication in future treatments. This review emphasizes immunostimulatory and hypersensitivity reactions.
自第一批诊断性抗体问世以来，生物制剂的应用迅速扩大；目前它们已广泛应用于肿瘤学、自身免疫性疾病、炎症性疾病和移植医学。其广泛应用导致了药物不良反应的增加。不良反应既源于直接的药理作用和免疫作用，也源于特定免疫反应的诱导。命名法，特别是单克隆抗体的命名法，可识别靶结构和器官以及来源物种，这有助于预测其作用和抗原特性。根据外来蛋白的程度，可能会诱导具有或不具有中和特性的同种异型或独特型抗抗体。生物制剂的药物不良反应通常取决于靶标，并可通过特定细胞因子途径的激活或抑制来解释。药物不良反应根据其发病机制进行分类，这增强了对发病机制的理解，并有助于变态反应学诊断措施的制定和未来治疗中预处理的规划。本综述强调了免疫刺激性和超敏反应。
