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Schematic overview of the events that alter the pharmacokinetics of repeated intravenous (IV) doses of pegylated liposomes. The first dose of pegylated liposomes stimulates the production of anti-PEG IgM antibodies by B cells within the spleen. This leads to the accelerated blood clearance of subsequent doses, during which circulating anti-PEG IgMs bind to the liposomes, initiating classical complement activation and decreasing blood circulation half-life.
