Monoclonal ABs + Vaccination

Question 1

What is the Antibody Binding Fragment, FAB?

Answer 1

Variable region that recognises antigens

Question 2

What is the FC region?

Answer 2

Responsible for binding to immune effector cells to elicit immune response

Question 3

List 2 features of a Monoclonal Antibody

Answer 3

• Recognise only one epitope/ antigen

- Produced from a single B lymphocyte

Question 4

List 3 outcomes of an AB binding with cell surface receptors, leading to activation/ inhibition of cell signalling

Answer 4

• Cell death induction

Antibody dependent cell mediated toxicity (ADCC)
activation;
- (FC binds to immune effector cells)

Complement dependent cytotoxicity (CDC) activation;
- (Results in cell lysis as membrane is attacked)

Question 5

What are Bispecific monoclonal ABs used for?

Answer 5

To target body’s own immune system (T and B cells)

Question 6

List 2 mechanisms of action of ABs

Answer 6

• Can be internalised to deliver cytotoxic agents

- Can be used to inhibit checkpoint receptors to inhibit T cell activation

Question 7

How can Monoclonal ABs be used in diagnostics?

Answer 7

Use of light emission (Fluorescence) or an Enzymatic reaction/ tag to identify specific cells

(Immunohistochemistry or Flow Cytometry)

Question 8

Lymphomas are divided into B or T cell.

Which type is most common?

Answer 8

B cell lymphoma

Question 9

Aggressive lymphomas are rapidly fatal, using MABs offers a significant improvement in outcome.

How are they diagnosed?

Answer 9

Via Biopsy and Histochemistry

CD20 immunohistochemistry to diagnose B cell lymphoma

Question 10

List 5 treatments for Lymphoma

Answer 10

• Chemo
• Radiotherapy
• Monoclonal AB therapy
• Targeted therapy
• Stem cell transplantation

Question 11

What’s higher grade, Follicular or Diffuse B cell lymphoma?

Answer 11

Diffuse B cell lymphoma

Question 12

Monoclonal AB therapy can lead to ADRs because of immune activation.

What can patients be pre-doses with to prevent hypersensitivity reactions?

Answer 12

• Steroids
• Antihistamines
• Paracetamol

(Avoid anti-hypertensive medications 12 hrs prior to infusion of MAB)

Question 13

Suggest a test that used ABs for detection

Answer 13

D-Dimer test; uses ABs to D-Dimer protein to measure presence/ level of circulating D-Dimer

(Elevated D-Dimer associated with clot/ elevated fibrin somewhere in body)

Question 14

Other than Lymhoma and Solid Cancers, list 3 indications for using Monoclonal ABs

Answer 14

• Autoimmune
• Endocrine
• Cardiology (Abciximab)

Question 15

Compare the 2 types of Immunisation

Answer 15

Passive: Immediate protection with temporary source of antibody

Active: Long term protection, formation of antibodies

Question 16

Compare Live and Inactivated vaccines

Answer 16

Live;

• Attenuated strain of disease, which replicates in host to provide immunity
• Usually only require 1 dose
• Can be unstable and revert to live strain-> Causing disease

Inactivated;
- Contain whole intact killed organism or components of organism