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Singh S, Kachhawaha K, Singh SK. Comprehensive approaches to preclinical evaluation of monoclonal antibodies and their next-generation derivatives. Biochem Pharmacol 2024; 225:116303. [PMID: 38797272 DOI: 10.1016/j.bcp.2024.116303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 05/03/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
Biotherapeutics hold great promise for the treatment of several diseases and offer innovative possibilities for new treatments that target previously unaddressed medical needs. Despite successful transitions from preclinical to clinical stages and regulatory approval, there are instances where adverse reactions arise, resulting in product withdrawals. As a result, it is essential to conduct thorough evaluations of safety and effectiveness on an individual basis. This article explores current practices, challenges, and future approaches in conducting comprehensive preclinical assessments to ensure the safety and efficacy of biotherapeutics including monoclonal antibodies, toxin-conjugates, bispecific antibodies, single-chain antibodies, Fc-engineered antibodies, antibody mimetics, and siRNA-antibody/peptide conjugates.
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Affiliation(s)
- Santanu Singh
- Laboratory of Engineered Therapeutics, School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - Kajal Kachhawaha
- Laboratory of Engineered Therapeutics, School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - Sumit K Singh
- Laboratory of Engineered Therapeutics, School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India.
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Finkel KA, Jung H, Kim H, Coleman DT. Protracted anaphylaxis and cytokine release syndrome 6 days after rituximab desensitization. Ann Allergy Asthma Immunol 2024; 133:112-114. [PMID: 38615738 DOI: 10.1016/j.anai.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Kelsey A Finkel
- Division of Allergy and Immunology, Department of Medicine, Henry Ford Health, Detroit, Michigan
| | - Heejin Jung
- Division of Allergy and Immunology, Department of Medicine, Henry Ford Health, Detroit, Michigan
| | - Haejin Kim
- Division of Allergy and Immunology, Department of Medicine, Henry Ford Health, Detroit, Michigan; Department of Medicine, Wayne State University, Detroit, Michigan
| | - David T Coleman
- Division of Allergy and Immunology, Department of Medicine, Henry Ford Health, Detroit, Michigan; Department of Medicine, Wayne State University, Detroit, Michigan; Department of Medicine, Michigan State University, East Lansing, Michigan.
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Xiao T, Yu X, Yang L, Duan X. Palmatine treats urticaria by reducing inflammation and increasing autophagy. Front Immunol 2023; 14:1268467. [PMID: 38035098 PMCID: PMC10682667 DOI: 10.3389/fimmu.2023.1268467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Chronic spontaneous urticaria (CSU) is mainly manifested as wheals and erythema on the skin accompanied by itching, which will cause emotional anxiety and seriously affect the quality of life in patients. Palmatine (PAL) is a main chemical component of Yajieshaba, which has been found to effectively alleviate the symptoms of food allergy. However, its role and mechanism in CSU remain unclear. The present study aimed to investigate the protective effect of PAL on CSU rats. Methods We replicated the CSU rat model by intraperitoneal injection of ovalbumin (OVA) in rats on days 0, 2, 4, and 14, with a double dose given on the last challenge. PAL, loratadine and saline were given by gavage from day 5 to day 14. We observed the skin pathologic changes, mast cell degranulation, immune factor levels, inflammatory response and autophagy-related protein expression in CSU rats. Results We found PAL treatment to be effective in alleviating CSU-like skin lesions and reducing itching and mast cell degranulation in rats. Compared with the OVA group, the levels of immune and inflammatory factors were significantly reduced, neutrophil recruitment was alleviated, suggesting a reduced inflammatory response. The autophagy results showed that PAL further increased the expression of LC3, Beclin-1 and p-LKB1, p-AMPK, Atg5, Atg12 and Atg5-Atg12, while P62 and p-p70S6K1 expression decreased. They collectively suggested that autophagic flux was activated after PAL treatment. However, there was an increase in the expression of LC3I, probably due to the fact that PAL induced its accumulation in order to provide substrate for the generation of more LC3II. Discussion Overall, PAL had a protective effect on CSU in normal rats, activated the expression of autophagy and improved the inflammatory response.
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Affiliation(s)
| | | | | | - Xiaohua Duan
- Yunnan Key Laboratory of Dai and Yi Medicines, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
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Villarreal-González RV, González-Díaz S, Vidal-Gutiérrez O, de la Cruz-de la Cruz C, Pérez-Ibave DC, Garza-Rodríguez ML. Interleukin-6 as a biomarker of hypersensitivity reactions in chemotherapeutics and monoclonal antibodies. J Oncol Pharm Pract 2023:10781552231204367. [PMID: 37817577 DOI: 10.1177/10781552231204367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
BACKGROUND In recent years, a new type of immediate hypersensitivity reaction known as cytokine release began to emerge, and within this phenotype of reactions, interleukin-6 is the most frequently associated with the presence during drug administration. Chemotherapeutic agents (QT) and monoclonal antibodies. OBJECTIVE Determine interleukin-6 levels in hypersensitivity reactions to QT and monoclonal antibodies. METHODS Observational and prospective study that was carried out from March 1, 2021 to March 1, 2022 in a university hospital in northeastern Mexico. Symptoms, severity, interleukin-6 levels, and skin tests of hypersensitivity reaction were evaluated at QT and monoclonal antibodies. RESULTS A total of 41 patients with oncological disease were included, the most frequent being ovarian cancer. Symptoms as initial hypersensitivity reaction were neuromuscular in taxanes and cutaneous in Platinums.41.5% presented elevation of interleukin-6, and it was found more frequently in presence of metastases. Positive skin tests were found more frequently in the carboplatin and doxorubicin groups. The most frequently presented phenotype was type I in paclitaxel, carboplatin, and doxorubicin, and mixed-reaction (type I and cytokine release) in oxaliplatin. CONCLUSION With the increasing prevalence of hypersensitivity reactions to biologic and antineoplastic therapies, interleukin-6 should be recognized as a biomarker in immediate hypersensitivity reactions to QT and monoclonal antibodies.
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Affiliation(s)
- Rosalaura V Villarreal-González
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - Sandra González-Díaz
- Faculty of Medicine, Regional Center of Allergy and Clinical Immunology, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - Oscar Vidal-Gutiérrez
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - Carlos de la Cruz-de la Cruz
- Department of Internal Medicine, Universidad de Monterrey, Christus Muguerza Alta Especialidad, Monterrey, Nuevo León, Mexico
| | - Diana C Pérez-Ibave
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - María L Garza-Rodríguez
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
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Klingebiel C, Belhocine W, Vitte J. Serum tryptase and drug hypersensitivity: why, how and what? A systematic review. Curr Opin Allergy Clin Immunol 2023; 23:294-299. [PMID: 37357783 DOI: 10.1097/aci.0000000000000916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
PURPOSE OF REVIEW Serum tryptase, a mast cell marker, provides clues for the mechanism, severity, and management of drug hypersensitivity induced by immunoglobulin E dependent or independent mast cell activation. RECENT FINDINGS The interpretation of serum tryptase levels has been challenged during the last 2 years by major advances in tryptase genetics and their rapid incorporation into clinical practice. On the contrary, new pathophysiological insight into nonmast cell-dependent immediate hypersensitivity has been gained. SUMMARY This review provides up-to-date information on the pathophysiology and recommended use and interpretation of tryptase in the context of drug hypersensitivity reactions as a function of their endotype.
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Affiliation(s)
| | | | - Joana Vitte
- University of Montpellier, IDESP, INSERM UMR UA 11, Montpellier
- Aix-Marseille Univ, IRD, APHM, MEPHI
- IHU Méditerranée Infection, Marseille, France
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Cernadas J, Vasconcelos MJ, Carneiro-Leão L. Desensitization in children allergic to drugs: Indications, protocols, and limits. Pediatr Allergy Immunol 2023; 34:e13965. [PMID: 37366205 DOI: 10.1111/pai.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/21/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Abstract
Any drug can potentially induce a hypersensitivity reaction. If after the allergological work-up the drug hypersensitivity reaction is confirmed, in most cases, the simple avoidance of the culprit drug and a suggestion of an unrelated alternative is enough. However, there are circumstances where the choice to stop the treatment affects the survival, the safety and/or the quality of life of the patient and the global outcome of the disease in question. When this occurs, drug desensitization can be the answer and should not be viewed as an extravagance, nor the pediatric age should be considered a contraindication. Drug desensitization in children can be safely and successfully performed, having a positive impact on the survival and overall prognosis. In general, the indications for DDS are the same in adults as in children. However, in this age group there are specificities that this paper aimed to describe, reviewing the mechanisms behind drug hypersensitivity and rapid drug desensitization, types of protocols, indications, and contraindications, as well as several technical aspects that are specific to the pediatric age.
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Affiliation(s)
- Josefina Cernadas
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
- Unidade de Imunoalergologia, Hospital Lusíadas Porto, Porto, Portugal
| | - Maria João Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
- Unidade de Imunoalergologia, Hospital Lusíadas Porto, Porto, Portugal
| | - Leonor Carneiro-Leão
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
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Peng YT, Yu RT, Chen AJ, Wen ZY, Xu J, Huang K, Wang P. Predicting the Risk of Nail Involvement in Psoriasis Patients: Development and Assessment of a Predictive Nomogram. Diagnostics (Basel) 2023; 13:diagnostics13040633. [PMID: 36832121 PMCID: PMC9955142 DOI: 10.3390/diagnostics13040633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Nail involvement has a tremendous impact on psoriasis patients. Early detection and prompt intervention of psoriatic nail damage are necessary. METHODS A total of 4290 patients confirmed to have psoriasis between June 2020 and September 2021 were recruited from the Follow-up Study of Psoriasis database. Among them, 3920 patients were selected and divided into the nail involvement group (n = 929) and the non-nail involvement group (n = 2991) by inclusion and exclusion criteria. Univariate and multivariable logistic regression analyses were performed to identify the predictors of nail involvement for the nomogram. Calibration plots, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the discriminative and calibrating ability and clinical utility of the nomogram. RESULTS Sex, age at onset, duration, smoking, drug allergy history, comorbidity, sub-type of psoriasis, scalp involvement, palmoplantar involvement, genital involvement, and PASI score were selected to establish the nomogram for nail involvement. AUROC (0.745; 95% CI: 0.725-0.765) indicated the satisfactory discriminative ability of the nomogram. The calibration curve showed favorable consistency, and the DCA showed the good clinical utility of the nomogram. CONCLUSION A predictive nomogram with good clinical utility was developed to assist clinicians in evaluating the risk of nail involvement in psoriasis patients.
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Affiliation(s)
| | | | | | | | | | | | - Ping Wang
- Correspondence: ; Tel.: +86-13271982269
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