A Multisource-Integrated Atlas of Adverse Reactions Associated with Immunological Agents

Immunological agents are vital for treating cancer and autoimmune diseases, yet their therapeutic potential is limited by complex multi-organ adverse drug reactions (ADRs). Existing databases lack comprehensive integration of real-world ADR patterns, quantitative risk metrics, and mechanistic insights. To address this, the comprehensive atlas of immunological agents and adverse drug reactions (IMADRD) was developed. IMADRD provides three core data components: (1) ADR occurrence features, leveraging 194,035 clinical and real-world datasets; (2) quantitative metrics, featuring 18,305 unique ADRs across 27 system organ classes (SOCs), including 75,425 incidence records, 15,248 severity annotations, and 131,494 signal intensities; and (3) Drug-ADR-protein interaction networks, connecting 315 drugs, 2586 ADRs, 2361 proteins, and 22,892 associations. Then, targeted analysis of immune checkpoint inhibitors (ICIs) further validates IMADRD’s practical utility. Through systematic evaluation of approximately 100 ICIs, IMADRD accurately identifies high-risk SOCs and uncovers rare but severe neuropsychiatric risks. More notably, IMADRD enables quantitative assessment of drug similarity through ADR profile comparisons, providing clinicians with evidence-based guidance for selecting alternative therapies or avoiding known high-risk agents. Overall, by integrating and analyzing multidimensional data, IMADRD advances our understanding of the biological mechanisms of ADRs and supports the development of personalized immunotherapy regimens. IMADRD is freely accessible at http://imadrd.bipslab.com .