title: Immunogenicity to biologics: mechanisms, prediction and reduction.
abstract: Currently, there is a significant rise in the development and clinical use of a unique class of pharmaceuticals termed as Biopharmaceuticals or Biologics, in the management of a range of disease conditions with, remarkable therapeutic benefits. However, there is an equally growing concern regarding development of adverse effects like immunogenicity in the form of anti-drug antibodies (ADA) production and hypersensitivity. Immunogenicity to biologics represents a significant hurdle in the continuing therapy of patients in a number of disease settings. Efforts focussed on the identification of factors that contribute towards the onset of immunogenic response to biologics have led to reductions in the incidence of immunogenicity. An in-depth understanding of the cellular and molecular mechanism underpinning immunogenic responses will likely improve the safety profile of biologics. This review addresses the mechanistic basis of ADA generation to biologics, with emphasis on the role of antigen processing and presentation in this process. The article also addresses the potential contribution of complement system in augmenting or modulating this response. Identifying specific factors that influences processing and presentation of biologic-derived antigens in different genotype and disease background may offer additional options for intervention in the immunogenic process and consequently, the management of immunogenicity to biologics.
authors.affiliation: MRC Centre for Drug Safety Science and Department of Molecular and Clinical Pharmacology, University of Liverpool, UK.
authors.forename: Swaminathan
authors.initials: S
authors.lastname: Sethu
authors.forename: Karthik
authors.initials: K
authors.lastname: Govindappa
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alhaidari
authors.forename: Munir
authors.initials: M
authors.lastname: Pirmohamed
authors.forename: Kevin
authors.initials: K
authors.lastname: Park
authors.forename: Jean
authors.initials: J
authors.lastname: Sathish
mesh_terms: D000818:Animals; D000906:Antibodies / Q000737:chemistry; D000888:Antibodies, Anti-Idiotypic / Q000737:chemistry; D000917:Antibody Formation; D017951:Antigen Presentation; D000938:Antigen-Presenting Cells / Q000276:immunology; D000941:Antigens / Q000737:chemistry; D001688:Biological Products / Q000627:therapeutic use*; D003165:Complement System Proteins; D000939:Epitopes / Q000737:chemistry; D006680:HLA Antigens / Q000737:chemistry; D006801:Humans; D007107:Immune System; D008954:Models, Biological; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000906:Antibodies; D000888:Antibodies, Anti-Idiotypic; D000941:Antigens; D001688:Biological Products; D000939:Epitopes; D006680:HLA Antigens; D003165:Complement System Proteins