Monoclonal Antibodies Flashcards
What are monoclonal antibodies?
- Man made proteins that act like human antibodies in the immune system
- Monovalent antibodies which bind to the same epitope + are produced from a single B lymphocyte clone
What are the regions of an antibody + their function
- FAB: antibody binding fragment containing hyper variable regions for recognition of antigens
- FC: responsible for binding to immune effector cells to elicit immune response
What does it mean if an antibody is monovalent?
Only recognise a single epitope
What is an epitope?
Site within antigen that antibody recognises and binds to
Function of the FAB region of antibody
Recognition of antigens
Function of FC region on antibody
Bind to immune effector cells to elicit immune response
Outline hydridoma generation
- immunising certain species against a specific epitope on antigen
- B lymphocytes harvested from spleen of mouse
- B lymphocyte fused with immortal myeloma cell line
- resulting hybridoma cells cultured so only hybridoma cells survive
- monoclonal antibody made
Types of monoclonal antibodies
Naked monoclonal antibodies
Conjugated monoclonal antibodies
Bispecific antibodies
Suffix for fully human monoclonal antibodies
-umab
Suffix of naked monoclonal antibodies from least to most human
-omab
-ximab
-zumab
-umab
What are bispecific antibodies?
Bind to two or more different epitopes
What are bispecific antibodies mostly used for?
To target tumour antigens + killer T cell
List some ways monoclonal antibodies can work
- binding with cell surface receptors > activate or inhibit signalling:
- cell death induction
- activated dependent cell mediated cytotoxicity activation
- complement dependent cytotoxicity activation
- internalisation
- blocking inhibitory effects on T cells > activates T cells
Uses of monoclonal antibodies
Lymphoma
Solid cancers
Autoimmune disease
Cardiology
Endocrine
What is lymphoma?
Cancer of mature lymphocytes - B + T cells
Types of lymphoma
B or T cell neoplasms
Most common type of lymphoma
B cell lymphoma with diffuse large B cells lymphoma
Diagnosis of lymphoma
- Biopsy
- histochemistry: CD20 immunohistochemistry to diagnose B cell lymphoma
Presentation of lymphoma
- enlarged lymph nodes
- night sweats
- weight loss
- fevers
Treatment of lymphoma
Chemotherapy
Radiotherapy
Monoclonal antibody therapy rituximab
Emerging targeting therapy
Stem cel transplantation
What do B cells express in immunohistochemistry in lymphoma?
CD20
What are patients given to prevent hypersensitivity reaction from monoclonal antibodies?
Pre medication: paracetamol, antihistamines, steroids
Management of infusion related reactions in monoclonal antibody treatment
- educate patient: ensure they know that they can still experience side effects despite pre medication
- pre medication: paracetamol, antihistamines, steroids
- start with slow infusion rate + increase slowly
What does the constant region of an antibody determine?
What class of antibody it is
e.g. IgA, IgE, IgM, IgG
