Anti-PEG antibodies: Properties, formation, testing and role in adverse immune reactions to PEGylated nano-biopharmaceuticals
Open accessAbstract
Conjugation of polyethylene glycols (PEGs) to proteins or drug delivery nanosystems is a widely accepted method to increase the therapeutic index of complex nano-biopharmaceuticals. Nevertheless, these drugs and agents are often immunogenic, triggering the rise of anti-drug antibodies (ADAs). Among these ADAs, anti-PEG IgG and IgM were shown to account for efficacy loss due to accelerated blood clearance of the drug (ABC phenomenon) and hypersensitivity reactions (HSRs) entailing severe allergic symptoms with occasionally fatal anaphylaxis. In addition to recapitulating the basic information on PEG and its applications, this review expands on the physicochemical factors influencing its immunogenicity, the prevalence, features, mechanism of formation and detection of anti-PEG IgG and IgM and the mechanisms by which these antibodies (Abs) induce ABC and HSRs. In particular, we highlight the in vitro, animal and human data attesting to anti-PEG Ab-induced complement (C) activation as common underlying cause of both adverse effects. A main message is that correct measurement of anti-PEG Abs and individual proneness for C activation might predict the rise of adverse immune reactions to PEGylated drugs and thereby increase their efficacy and safety.
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In preclinical studies, the presence of anti-PEG IgM in animal serum accelerated nanoparticle clearance.
“In preclinical studies, the presence of anti-PEG IgM in animal serum accelerated nanoparticle clearance and caused a complete loss of the efficacy of mRNA therapeutics217,218.”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [218]
In preclinical studies, the presence of anti-PEG IgM in animal serum caused a complete loss of the efficacy of mRNA therapeutics.
“In preclinical studies, the presence of anti-PEG IgM in animal serum accelerated nanoparticle clearance and caused a complete loss of the efficacy of mRNA therapeutics217,218.”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [218]
Anti-PEG antibodies might heighten the risk of allergic reactions in certain individuals and impede vaccine efficacy.
“Anti-PEG antibodies have been reported in 40% of the population, which might heighten the risk of allergic reactions in certain individuals and impede vaccine efficacy218.”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [218]
Anti-PEG antibodies have been reported in 40% of the population.
“Anti-PEG antibodies have been reported in 40% of the population, which might heighten the risk of allergic reactions in certain individuals and impede vaccine efficacy218.”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [218]
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Flagged first, then by citations
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- Authors
- Kozma, G. T., Shimizu, T., Ishida, T., & Szebeni, J.
- Affiliations
- Semmelweis University (HU)
- Tokushima University (JP)
- Venue
- Advanced Drug Delivery Reviews
- Publisher
- Elsevier BV
- Published
- 2020
- Volume
- 154-155
- Pages
- 163-175
- ISSN
- 0169-409X (ISSN-L)
- OpenAlex
- W3046633757
- Cited by
- 696
- References
- 105
- Citations by year
- 2026: 139 · 2025: 143 · 2024: 100 · 2023: 127 · 2022: 106 · 2021: 72 · 2020: 8
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Advanced Drug Delivery Reviews (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (publishedVersion, cc-by-nc-nd)
- Funders
- European Union Horizon 2020 (825828)
- Applied Materials and Nano- technology Center of Excellence, Miskolc University
- Topics
- Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Monoclonal and Polyclonal Antibodies Research
- Life Sciences › Immunology and Microbiology › Immunology › Biosimilars and Bioanalytical Methods
- Keywords
- anti-PEG antibodies, polyethylene glycol, PEGylation, accelerated blood clearance, hypersensitivity, complement activation, anti-drug antibodies, IgM and IgG antibodies, immunogenicity, drug safety, anaphylaxis
- MeSH terms
- Animals, Antibodies, Biological Assay, Humans, Polyethylene Glycols, Nanomedicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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