Monoclonal antibodies

Question 1

Define monoclonal antibodies. (5)

Answer 1

Monovalent antibodies (have affinity for only one antigen) that are produced from a single B lymphocyte clone, which has been fused with a myeloma cell to make it immortal, now called a hydrindoma.

Question 2

Describe types of monoclonal antibody. (12)

Answer 2

Murine: 0% human, -omab
Chimeric: 65% human, -ximab
Humanised: >90% human, -zumab
Fully human: 100% human, -umab.

Question 3

Describe the half lives and the immunogenicity of each type of monoclonal antibody. (3)

Answer 3

Murine - chimeric - humanised - fully human
Short t1/2 ———————————— long t1/2
High immunogenicity — low immunogenicity

Question 4

Describe how monoclonal antibodies work. (4)

Answer 4

Bind to cell surface to: induce cell death, prevent cell-to-cell or intracellular transmission, activate T cells.

Question 5

Describe the uses of monoclonal antibodies. (4)

Answer 5

Testing - pregnancy testing against beta hCG.

Treatments - cancer, autoimmune, endocrine.

Question 6

Name three monoclonal antibodies and state their function. (9)

Answer 6

Trastuzumab - inhibition of HER2 signalling in breast cancers.
Infliximab - inhibition of TNF alpha in autoimmunity.
Denosumab - inhibition of RANK ligand on osteoclasts in osteoporosis.

Question 7

Describe the side effects of an infusion reaction. (5)

Answer 7

Nausea, fatigue, facial flushing, hypotension, pain.

Question 8

Describe the steps taken before an infusion of monoclonal antibodies to help prevent side effects. (5)

Answer 8

Premedication - paracetamol, steroids, antihistamines
Starting at a slow infusion rate
Patient communication of how they are feeling
Patients stopping antihypertensive medication at least 12 hours before.