IgM-mediated Pseudoallergy for Drug Delivery

The initial antibody produced after being exposed to an antigen is called IgM. The classical complement pathway can be highly effectively activated by IgM pentamers with ten binding sites. In the spleen, B-1 cells produce anti-PEG IgM independently of T lymphocytes. The ABC phenomenon results from C3 opsonization brought on by anti-PEG IgM binding, which is then cleared by the liver's Kupffer cells.

To summarize, the clinical translation of nanomedicines such as PEGylated liposomes is hampered by IgM-mediated pseudoallergy. Engineering techniques to lower this risk of hypersensitivity have been guided by the elucidation of the molecular pathways involving complement activation and anti-PEG IgM. Safe, recurrent administration of medications using nanoparticles may be made possible by further developments to decrease IgM reactions or specifically eliminate anti-PEG IgM. Further comprehension of the pathways leading to pseudoallergy may potentially clarify other inexplicable infusion reactions to pegylated biopharmaceuticals.