Recognizing Friend from Foe
The immune system scrambles into action when a foreign entity is detected, but not all foreign entities mean harm. New solutions are needed to teach the immune system to recognize biological drugs as partners rather than plunderers.
Werner Cautreels |
The human immune system is an incredible defense mechanism that has the ability to interrogate and respond to any harmful entity (or ‘antigen’) that it is exposed to. When we are exposed to viruses, our dendritic cells sample the particles, process them, and then mobilize the immune system into action, resulting in the production of antibodies against the virus. The same mechanism has been exploited for vaccination, of course.
But the immune system also has a darker side – antibodies can form in response to anything deemed as ‘foreign,’ including biological medicines that are intended to improve – or to save – the patient’s life. A well-known example is coagulation factor VIII – a clotting protein required by patients with hemophilia A. In a surprisingly large percentage of patients (over 30 percent), the immune system treats factor VIII as if it were a harmful entity and starts to make anti-drug antibodies (ADAs). This often results in a loss of efficacy and may also cause severe hypersensitivity reactions, including anaphylaxis.
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