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The complex clinical picture of side effects to biologicals

Hausmann, Oliver V. and Seitz, Michael and Villiger, Peter M. and Pichler, Werner J.. (2010) The complex clinical picture of side effects to biologicals. The medical clinics of North America, Vol. 94, no. 4. pp. 791-804.

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Official URL: http://edoc.unibas.ch/dok/A6007638

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Abstract

Biologicals are proteins used as drugs. Biologicals target clearly defined molecular structures, being part of established pathogenetic pathways. Therefore, their focused mode of action seems to render them superior to classic small molecular drugs regarding "off-target" adverse drug reactions (ADR). Nevertheless, the increasing use of biologicals for the treatment of different diseases has revealed partially unexpected adverse reactions. The often direct interaction of a biological with the immune system provides a clue to most side effects, which have consequently been subclassified, based on pathogenetic principles, into 5 subtypes named alpha, beta, gamma, delta, and epsilon, reflecting overstimulation (high cytokine values, type alpha), hypersensitivity (type beta), immune deviation (including immunodeficiency, type gamma), cross-reactivity (type delta), and nonimmune mediated side effects (type epsilon). This article presents typical clinical manifestations of these subtypes of ADR to biologicals, proposes general rules for treating them, and provides a scheme for a thorough allergological workup. This approach should help in future handling of these often very efficient drugs.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Kopfbereich > Neurochirurgie (Mariani)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Kopfbereich > Neurochirurgie (Mariani)
UniBasel Contributors:Hausmann, Oliver Nic
Item Type:Article, refereed
Article Subtype:Further Journal Contribution
Bibsysno:Link to catalogue
Publisher:Saunders
ISSN:0025-7125
Note:Publication type according to Uni Basel Research Database: Journal item
Last Modified:23 May 2014 08:33
Deposited On:23 May 2014 08:33

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