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Vol 23. no 1
March 2018

Immunological mechanisms responsible for biologic agents’ adverse reactions (summary)
Marta Skoczyńska, Piotr Wiland
As the group of biologic agents registered in Poland is becoming more and more diversified and availability of therapeutic programs using these drugs in many medical specialties is increasing, the present work focuses on immunological mechanisms of adverse effects of biologic therapies. The problem of these drugs’ adverse effects along with legal issues, the classification in juxtaposition to the classification for „conventional” drugs, as well as on the mechanisms underlying biologic therapies’ side effects with some examples. Methods of prophylaxis and directions for possible future research are outlined. According to Pichler’s classification from 2006, there are 5 types of basic immunological mechanisms behind biologic agents’ adverse effects: type alpha – reactions related to cytokines, including the „cytokine storm”; type beta – hypersensitivity reactions, which may be either immediate or delayed, with some of them related to anti – drug antibodies, type gamma – reactions caused by „immunological imbalance syndrome”, related either to immunosuppression or to autoimmunization; type sigma – cross reactivity and type ypsilon – non – immunological reactions, related to new and unexpected side effects observed in vivo. Proper qualification to biologic treatment as well as the continuous monitoring are essential to adverse reactions’ prevention. As of now there are no guidelines for monitoring either biologic drugs’ through levels or routine tests for anti – drug antibodies levels. More research is needed in order to assess the potential usefulness of such monitoring, as well as to create strategies of further follow – up of patients undergoing biologic therapies.
Keywords: biological treatment, adverse effects, immunological mechanisms
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