Article

Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Service d'aide à la décision clinique
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates

  • You can purchase this item in Pay Per ViewPay per View - FAQ : 30,00 € Taxes included to order
    Pages Iconography Videos Other
    10 0 0 0


Annales de Dermatologie et de Vénéréologie
Volume 139, n° S2
pages 58-67 (avril 2012)
Doi : 10.1016/S0151-9638(12)70112-6
Anticorps anti-médicament, auto-anticorps et traitements biologiques du psoriasis
Anti-drug antibodies, auto-antibodies and biotherapy in psoriasis
 

D. Jullien
Université de Lyon, Lyon, F-69003, France; Université Lyon 1, faculté de médecine Lyon EST, France; Hospices Civils de Lyon, Service de Dermatologie, Hôpital Edouard Herriot, Lyon, F-69437, France 

Résumé

La mise sur le marché d’un nombre important de thérapies biologiques ciblées (anticorps monoclonaux, protéines de fusion) a placé ces produits au centre des stratégies de prise en charge des formes modérées et sévères du psoriasis, de la polyarthrite rhumatoïde et de la maladie de Crohn. Une des préoccupations liée à l’administration de ces molécules est que, parce que la plupart sont des glycoprotéines immunogènes, elles induisent une réponse immune indésirable qui s’accompagne de la production d’anticorps antimédicament spécifiques (ADA). Le développement de thérapies ciblées reposant sur des molécules du soi (à partir de séquences géniques humaines), comme des anticorps « humains » recombinants, ou des protéines de fusion, a aidé à réduire la production d’ADA, mais ceci ne permet pas d’éviter toute immunogénicité. Une perte d’efficacité et des problèmes de tolérance comme des réactions anaphylactiques ou des vascularites accompagnent le développement d’ADA. A côté des réactions immunitaires vis-à vis-des biothérapies, phénomène global qui concerne toute cette classe, certaines molécules comme les anti-TNF⍺ peuvent en plus entraîner une réponse auto-immune, qui se manifeste notamment par la production d’anticorps antinucléaires (ACAN). Le développement d’ACAN a été associé au lupus induit, et dans le psoriasis il pourrait être un marqueur d’échec au traitement par anti-TNF⍺. En se centrant sur le psoriasis, cet article fait le point sur les conséquences et les défis liés au développement d’anticorps anti-biothérapies et d’autoanticorps en thérapeutique humaine.

The full text of this article is available in PDF format.
Summary

The approval of substantial numbers of targeted biologic therapies (e.g., monoclonal antibodies, fusion proteins) for treatment of inflammatory diseases has positioned these drugs as important to fight chronic disorders such as psoriasis, rheumatoid arthritis and Crohn’s disease. One of the concerns raised with the administration of biologic therapies is that because most of them are immunogenic glycoproteins they induce undesirable immune response leading to the generation of specific anti-drug antibodies (ADA). The development of “self” derived protein therapeutics (comprised of human germline sequence), such as recombinant “human” antibodies, helped to reduce the production of ADA but did not avoid all immunogenicity. Reduced efficacy and safety issues such as anaphylaxis or vasculitis accompany the development of ADA. In addition to immune reactions directed against the biologic therapies as a whole, some of them such as anti-TNF⍺ are able to induce auto-immune response, notably antinuclear antibody (ANA). ANA development was associated with induced lupus and in psoriasis it was suggested that it may act as a marker of treatment failure to anti-TNF⍺. With a focus on psoriasis, this paper makes a current point on the consequences and challenges of the development of anti-drug antibodies and auto-immunity in patients who receive biologic therapies.

The full text of this article is available in PDF format.

Mots clés : Psoriasis, Immunogénicité, Anticorps neutralisant, Anticorps antinucléaire, Anti-TNF⍺ Anti-infliximab, Anti-étanercept, Anti-adalimumab, Anti-ustekinumab

Keywords : Psoriasis, Immunogenicity, Antinuclear antibodies, Neutralizing antibody, Anti-TNF⍺, Anti-infliximab, Anti-etanercept, Anti-adalimumab, Anti-ustekinumab




© 2012  Elsevier Masson SAS. All Rights Reserved.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline