Martin Dubravec, M.D.  

The Hilltop Allergy Letter

Volume 17    Number 4

September 2018 – November 2018





              We welcome all new and established patients to our newsletter.  This is formulated four times a year to inform patients and the medical community with regard to new developments in asthma, allergies, and clinical immunology.  Please feel free to take this home with you and share it with family and friends. 


What are Biologics?


A whole new set of medications/therapies have become very popular and are increasingly used to treat a variety of diseases of the immune system. I would like to review this class of medication called biologics.


Biologics have been around for a very long time. Vaccines can be considered biologics. Allergy shots can also be considered biologics. As opposed to a pharmaceutical, a biologic medication is a medicine that is not a chemical like Motrin or Tylenol. Rather, a biologic represents a molecule that the body may naturally make or that may trigger a beneficial natural response in the body.

Biologics include medications such as Xolair (omalizumab). Xolair (omalizumab) was one of the first biologics to be  used extensively by allergists.. Xolair (omalizumab) is actually a partially a partial mouse/human antibody fused together. This allows the antibody to be mass produced in mice and allows the human body to tolerate this antibody as it is partially based on human protein. This antibody is important in treating asthma and chronic hives. Since its availability in 2004, it has been shown to have a remarkably safe track  record. This biologic has been found to be found to be of  benefit in preventing certain, but not all, severe food allergy reactions in patients with severe food allergy histories.

                Some biologics have been developed to attack cancer. Antibodies are infection fighting proteins that are typically used to fight infection. Certain biologics (also known as monoclonal antibodies) are used to specifically target cancerous cells and allow the immune system to destroy these cells.

                Other forms of biologic therapy include allergy shots. With allergy shots, proteins from the outside environment (that falsely stimulate the immune system) are given in a very careful and gradually increasing dose which reeducates the immune system not to react to these harmless substances in the environment.

                Vaccines are a form of biologic therapy. Vaccines do the opposite of allergy shots. Vaccines attempt to stimulate an immune response so that when an individual comes across a virus or bacteria, the immune system will recognize that virus or bacteria instantly and therefore prevent infection by killing off any bacterial or virus before it has a chance to grow and multiple in the body.

                Biologics are not without problems or side effects. Patients can develop severe allergic reactions to these therapies. Biologics do not always work. There is concern as to whether or not biologics can stimulate autoimmune disease. However, on balance, biologics have been shown to be extremely helpful and safe.

                One of the challenges with biologic medication is that this medication is often extremely expensive. From a technical stand point, the amount of bio engineering involved in producing these biologics is extensive. Not only that, but producers of these biologics must be on the lookout for  mutations in these biologics that could cause these biologics to be mass  produced in a potentially harmful way. Fortunately, this has not been noted in the treatment of our patients who are currently receiving biologics. The current biologics that are used in our office in addition to Xolair (omalizumab) and allergy shots include the following: Fasenra, Nucala, and Dupixent.

                If you have any questions with regard to biologics, please do not hesitate to contact our office. The future at this point, we can expect a continued and market increase in the number of biologics that are available for patients. Hopefully, the cost of these medications will decrease over time.


Your Input Is Needed.


The Cadillac area has seen the development of a female roller derby club. Dr. Dubravec has expressed his interest in having his staff form a team for roller derby and he would sponsor them.   Dr. Dubravec and many of his allergy shot patients have  personally witnessed the potential that his staff has in toughness for roller derby. If you have an interest in his staff developing a roller derby team, please express this to his employees.





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Allergy and Asthma Specialists of Cadillac