Table 3 |
||
|
Proposed classification of adverse side effects of biological agents9 |
||
| Classification |
Mechanism (s) |
Clinical features |
|
|
||
| Type α |
High cytokine & cytokine release syndrome |
Symptoms will depend on the cytokine or cytokine being targeted e.g., high levels
of INF-α may cause 'flu-like symptoms and anti- CD3 (muromunab) may induce cytokine
release syndrome, which may include the following symptoms: flushing, arthralgias,
capillary leak syndrome with pulmonary edema, encephalopathy, and severe gastrointestinal
symptoms |
| Type β |
Hypersensitivity |
Immediate (IgE) |
| Delayed (IgG or T cell) |
||
| Type γ |
Immune or cytokine imbalance syndrome |
Autoimmunity |
| Allergic/atopic disorders |
||
| Impaired function (immunodeficiency) |
||
| Type δ |
Cross-reactivity |
Will depend on the function of the cross-reacting antigen; e.g., Acneiform eruptions
are commonly seen with cetuximab, an anti- epidermal growth factor receptor (EGFR)
mAb possibly due to cross-reactivity between skin ERFR. |
| Type ε |
Non-immunologic side-effects |
Varies with the function of the biological agent; Interferon-α frequently associated
with neuropsychiatric adverse effects |
|
|
||
|
Cox Allergy, Asthma & Clinical Immunology 2009 5:4 doi:10.1186/1710-1492-5-4 |
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