Li Lichen, Naisbitt Dean J, Sun Yonghu, Zhang Furen
Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong, China.
Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Clin Exp Allergy. 2024 Dec;54(12):973-983. doi: 10.1111/cea.14583. Epub 2024 Oct 20.
Biological agents are widely used across medicine, including for immune-mediated skin conditions such as psoriasis and atopic dermatitis. When used to treat a relevant pathological process, they demonstrate impressive efficacy and credible safety, helping to achieve remission and improved function and quality of life. However, with their expanded use, awareness and understanding of adverse reactions to biologicals have also increased. Herein, we discuss the pathomechanism of adverse reactions to biological agents used to treat skin conditions and apply these to Pichler's classification system. This classification differentiates five distinct types, namely overstimulation (type α), hypersensitivity or immunogenicity (β), immunodeviation (γ), cross-reactivity (δ) and nonimmunologic adverse reactions (ε). This classification covers most types of adverse reactions associated with use of biological agents and could be used to better understand the reaction pathogenesis and manage the clinical features of biological adverse effects.
生物制剂在医学领域广泛应用，包括用于治疗银屑病和特应性皮炎等免疫介导的皮肤病。当用于治疗相关病理过程时，它们显示出令人印象深刻的疗效和可靠的安全性，有助于实现病情缓解，并改善功能和生活质量。然而，随着其使用范围的扩大，对生物制剂不良反应的认识和理解也有所增加。在此，我们讨论用于治疗皮肤疾病的生物制剂不良反应的发病机制，并将其应用于皮克勒分类系统。该分类区分了五种不同类型，即过度刺激（α型）、超敏反应或免疫原性（β型）、免疫偏离（γ型）、交叉反应（δ型）和非免疫性不良反应（ε型）。该分类涵盖了与生物制剂使用相关的大多数不良反应类型，可用于更好地理解反应发病机制并处理生物制剂不良反应的临床特征。
