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Morael t1_itjctyp wrote

Medicinal chemist here.

Two things: A full immune response is usually the body's response to biologics, not just random chemicals. The vast majority of marketed drugs are not biologics. There are certainly drugs that are biologics, though, so it's still a fair point of quandary.

The body does try to eliminate all foreign bodies, whether they're biologics or not. There's multiple areas of drug design that are dedicated to getting around this via either small changes to the chemical structure to combat digestion and enzymatic breakdown, clever formulation to assist with rapid transfer into the body... And most likely both of these things.

The drugs you see marketed usually don't have problems with immune response because they'd never see the light of day on the market of they did. Many drugs get pulled in clinical trials for adverse effects of various types, which is why you don't see them.

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baggier t1_itjvxjy wrote

To continue - there are two main types of drugs - first small molecules (aspirin, speed, phenacetin etc). These molecules are generally too small for the immune system to see and dont have enough "docking" sites for the immune molecules to latch on to. Many modern drugs are big (e.g. proteins such as artificial insulin) and they are quite likely to generate immune responses if they dont look like what the body expects. They have lots of molecular sites for the immune molecules to grab and recognize. Often these molecules are "pegylated" by the chemists, surrounded by nonimmunogenic polymers that sheild the large molecule from the immune system.

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JeebusJones t1_itmjava wrote

Just adding on a definition for "biologic" from wikipedia for the benefit of others like me who aren't familiar with the term:

>A biopharmaceutical, also known as a biological medical product, or biologic, is any pharmaceutical drug product manufactured in, extracted from, or semisynthesized from biological sources

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rmdingler37 t1_itntykw wrote

Armchair Reddit expert, medical school non-graduatte here, but there are drugs that are designed to promote immune response.

https://www.google.com/search?q=drugs+that+prompt+immune+response&rlz=1C1CHBF_enUS914US914&oq=drugs+that+prompt+immune+&aqs=chrome.2.69i57j33i160l2.11350j0j7&sourceid=chrome&ie=UTF-8

Recognizing the introduced chemical cocktail as beneficial is as important to the drug's efficacy as is the body's tolerance of alcohol to drunkenness.

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