title: Infections associated with monoclonal antibody and fusion protein therapy in humans.
abstract: Monoclonal antibodies (mAbs), especially those that interact with immune or hematologic leukocyte membrane targets, have changed the outcome of numerous diseases. However, mAbs can block or reduce immune cells and cytokines, and can lead to increased risk of infection. Some of these risks are predictable and can be explained by their mechanisms of action. Others have been observed only after the mAbs were licensed and used extensively in patients. In this review, we focus on infectious complications that occur upon treatment with mAbs or Fc-containing fusion proteins targeting leukocyte membrane proteins, including CD52, CD20, tumor necrosis factor, VLA4, CD11a and CTLA4. We report their known infectious risks and the recommendations for their use. Although most of these drugs are clinically safe when the indications are respected, we emphasize the need for regular updating of pharmacovigilance data.
authors.affiliation: Allergology and Clinical Immunology Unit, Pediatric Unit, Clocheville Hospital, "CDIG" François Rabelais University, Tours, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Uettwiller
authors.forename: Emilie
authors.initials: E
authors.lastname: Rigal
authors.forename: Cyrille
authors.initials: C
authors.lastname: Hoarau
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D000954:Antigens, Surface / Q000276:immunology; D006801:Humans; D007107:Immune System / Q000187:drug effects; D007141:Immunoglobulin Fc Fragments / Q000009:adverse effects* / Q000235:genetics / Q000276:immunology / Q000627:therapeutic use; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D007239:Infections / Q000209:etiology* / Q000276:immunology; D060735:Pharmacovigilance; D011993:Recombinant Fusion Proteins / Q000009:adverse effects* / Q000235:genetics / Q000276:immunology / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D000954:Antigens, Surface; D007141:Immunoglobulin Fc Fragments; D011993:Recombinant Fusion Proteins; D014409:Tumor Necrosis Factor-alpha