Monoclonal Antibodies

Question 1

Name the structures that allow binding of antibodies with antigens

Answer 1

Hypervariable region - allows recognition of antigens

Fab regions - binds antigen

Epitope - binds antigen to antibody

Question 2

Describe how monoclonal antibodies are produced

Answer 2

Generation of hybridoma by immunisation of rodent against specific epitope -> harvest B cells from spleen

Fuse B cells with immortal myeloma cell line to produce hybridoma

Culture hybridomas so only they are left in the culture

Select hybridomas -> produce monoclonal antibodies from hybridomas selected

Question 3

What are the types of monoclonal antibody

Answer 3

Naked monoclonal antibody - nothing added to it. Produced by rodents or genetically engineered

Conjugated monoclonal antibody - contain cytotoxin bound to antibody. Is internalised, broken down and releases cytotoxin to destroy cancer cell

Bispecific monoclonal antibody - brings B and T cells close together so T cell can destroy B cell

Question 4

What are the ways in which monoclonal antibodies work by

Answer 4

Bind with surface receptor to activate or inhibit signalling within the cell

Bind to induce cell death

Bind with surface receptor to activate: antibody dependent cell mediated cytotoxicity or complement dependent cytotoxicity

Bind with receptor and are internalised to deliver toxins to cell

Block inhibitory effects of T cells to activate T cells to kill cancer cells

Question 5

What is lymphoma divided into, what organs does it affect and name some common symptoms

Answer 5

Lymphoma is divided into B and T cell neoplasms

Typically causes lymphadenopathy but may involve spleen, bone marrow, liver, skin, testes, bowel

Symptoms: night sweats, fever, weight loss

Question 6

How is lymphoma graded and name a type of lymphoma for each grade

Answer 6

Low grade - not very aggressive. May only require monitoring. E.g. follicular lymphoma

High grade - very aggressive. E.g. diffuse larger B cell lymphoma

Question 7

What is the treatment for lymphoma

Answer 7

Chemo or Radio

Monoclonal antibody therapy

Target therapy

Stem cell transplant

Question 8

When monoclonal antibodies are used in the treatment of cancer, what other drugs are used before and during treatment

Answer 8

Before - antihistamines, steroids, paracetamol, antiemetics

Chemotherapy and steroids also given during

Question 9

Name some side effects of monoclonal antibody use

Answer 9

No/mild symptoms - fatigue

Mild or severe infusion reaction

Heaviness in chest

Nausea

Hyperventilation

Vomiting

Shivering and Rigors

Question 10

Name some monoclonal antibodies used in cancer

Answer 10

Trastuzumab

Bevacizumab

Nivolumab

Question 11

Name some monoclonal antibodies used in autoimmune disease

Answer 11

Infliximab

Adalimumab

Question 12

Name some monoclonal antibodies used for conditions other than autoimmune and cancer

Answer 12

Abciximab

Denosumab

Question 13

What does trastuzumab do and what is it used for

Answer 13

Trastuzumab inhibits Her-2 signalling and is used for Her-2 positive breast cancer

Question 14

What does bevacizumab do and what is it used for

Answer 14

Bevacizumab inhibits VEG-F signalling and is used for anti-antiogenic cancer therapy

Question 15

What does nivolumab do and what is it used for

Answer 15

Nivolumab inhibits PV1 signalling -> inhibits checkpoints stopping T cells from destroying cells

Is used for melanoma

Question 16

What do inflixiamb and adalimumab do and what are they used for

Answer 16

They inhibits TNF-alpha

Used for RA, Crohn’s and ulcerative colitis

Question 17

What does abciximab do and what is it used for

Answer 17

Abciximab inhibits platelet glycoprotein IIb/IIIa and is used to prevent coagulation in coronary angioplasty

Question 18

What does denosumab do and what is it used for

Answer 18

Denosumab inhibits RANK ligand on osteoclasts and is used for osteoporosis