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Proposed type-2 T-cell independent (TI-2) response mechanism for the formation of α-PEG Abs and the ABC effect. Splenic B cells are stimulated by an initial dose of PEGylated therapeutic and produce α-PEG IgM. These antibodies then associate with subsequent doses of PEGylated systems and activate complement proteins, which then opsonize PEGylated system and lead to its eventual clearance through hepatic MPS cells. Reprinted from Ref 8 by permission from Macmillan Publishers Ltd.
