Table 3 Proposed classification of adverse side effects of biological agents9
From: How safe are the biologicals in treating asthma and rhinitis?
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) |
| Â | Â | Delayed (IgG or T cell) |
Type γ | Immune or cytokine imbalance syndrome | Autoimmunity |
| Â | Â | Allergic/atopic disorders |
| Â | Â | 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 |