Fernandez L, Bustos R H, Zapata C, Garcia J, Jauregui E, Ashraf G M
Evidence-Based Therapeutic Group, Clinical Pharmacology, Universidad de La Sabana, Chia, Colombia.
Riesgo de Fractura S.A.-CAYRE, Colombia.
Curr Protein Pept Sci. 2018;19(10):958-971. doi: 10.2174/1389203718666170828123449.
Currently it is well known that all biological drugs, including those with a fully human structure, are capable of inducing a host immune response known as immunogenicity [1]. The presence of ADAs can condition the drug´s level and action, thus modifying the therapeutic effect and even the safety profile by its mechanism of action - neutralizing or non-neutralizing - and / or an increase in its clearance. Immunogenicity is a dynamic factor to be taken into account in biological therapy, especially in long-term treatments, and as a relevant aspect in the assessment of secondary response loss [2]. With the above, not only the knowledge but also the management of the immunogenicity of the different biological treatments, represent a useful instrument for optimization of the strategies of use for each drug, and in the design of predictive models of response, which finally permits a significant improvement in the efficacy and safety profile, aiming to a personalization of the therapies, especially in patients with autoimmune diseases, genetic disorders and cancer [3]. This review summarizes the events of immunogenicity that produce the biological drug, the factor that influence to immunogenicity and the assessment of immunogenicity.
目前众所周知,所有生物药物,包括那些具有完全人源结构的药物,都能够引发一种称为免疫原性的宿主免疫反应[1]。抗药物抗体(ADAs)的存在会影响药物的水平和作用,从而通过其作用机制——中和或非中和——和/或增加其清除率来改变治疗效果,甚至改变安全性。免疫原性是生物治疗中需要考虑的一个动态因素,尤其是在长期治疗中,并且是评估继发反应丧失的一个相关方面[2]。综上所述,不仅对不同生物治疗的免疫原性的了解,而且对其管理,都是优化每种药物使用策略以及设计反应预测模型的有用工具,最终可显著提高疗效和安全性,旨在实现治疗的个性化,尤其是在自身免疫性疾病、遗传性疾病和癌症患者中[3]。本综述总结了生物药物产生的免疫原性事件、影响免疫原性的因素以及免疫原性的评估。