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[Therapeutic monoclonal antibodies: update on the risk of opportunistic infections].
- Source :
-
Medecine sciences : M/S [Med Sci (Paris)] 2009 Dec; Vol. 25 (12), pp. 1135-40. - Publication Year :
- 2009
-
Abstract
- The large experience accumulated with the therapeutic use of monoclonal antibodies has revealed undesirable effects, among which opportunistic infections when prescribed in inflammatory or hematological diseases. This deleterious effect is a direct consequence of the immunosuppression induced by these antibodies through the blockade of several key pathways involved in both innate and adaptative immune responses, including migration of effector cells, depletion of B or T lymphocytes, inhibition of key cell-cell interactions. Four antibodies are concerned, targeting CD52, CD20, TNF-a and VLA-4, and major risks include activation of latent tuberculosis, or of normally silent viruses. Precise evaluation of these risks and understanding of their mechanisms have now led to the improvement of clinical safety, based on the detection of patients at risk, weighting of the benefit/risk ratio, and a very rigorous detection of latent infections before the onset of treatment by monoclonal antibodies know to induce immunosuppression.
- Subjects :
- Alemtuzumab
Antibodies, Monoclonal therapeutic use
Antibodies, Monoclonal, Humanized
Antibodies, Monoclonal, Murine-Derived
Antibodies, Neoplasm adverse effects
Antibodies, Neoplasm therapeutic use
Antigens, CD immunology
Antigens, CD20 immunology
Antigens, Neoplasm immunology
CD52 Antigen
Cohort Studies
Glycoproteins immunology
Humans
Immunosuppression Therapy adverse effects
Integrin alpha4beta1 immunology
Meta-Analysis as Topic
Opportunistic Infections epidemiology
Recurrence
Retrospective Studies
Rituximab
Tuberculosis etiology
Tumor Necrosis Factor-alpha antagonists & inhibitors
Tumor Necrosis Factor-alpha immunology
Virus Activation
Antibodies, Monoclonal adverse effects
Opportunistic Infections etiology
Subjects
Details
- Language :
- French
- ISSN :
- 0767-0974
- Volume :
- 25
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Medecine sciences : M/S
- Publication Type :
- Academic Journal
- Accession number :
- 20035693
- Full Text :
- https://doi.org/10.1051/medsci/200925121135