Monoclonal antibodies Flashcards
What are monocloncal antibodies?
Monovalent antibodies that bind to the same epitope and are produced from a single B lymphocyte clone
Describe how monoclonal antibodies are made
- Immunise mouse with specific epitope of an antigen
- Harvest the B-lymphocytes from the spleen of the mouse
- Fuse the B lymphyoctes with immortal myeloma cell line (not containing other immunoglobin producing cells
- Creates hybridoma cella that are cultured in vitro
- Selected hybridomas are found making a specific desired clonal antibody
What are naked monoclonal antibodies
The antibody on its own
What are conjugated monoclonal antibodies?
The antibody fused with a drug
Allows tiny concentrations of v toxic compounds to be diretly delivered to the source e.g. cancer cells to minimise the effects on other tissues
What are bispecific monoclonal antibodies?
- New early phase mab
- Can bind to B or T cells with different aims
- Utilise our own immune system rather than using toxic chemicals
What is lymphoma?
- B or T cell neoplasms - clonal proliferations of lymphoid cells
- Produces enlargement of lymph nodes
- Spleen , bone marrow and other areas of body (extra-nodal) may be involved
- Symptoms: drenching night sweats, fevers, weight loss or none of these!
What do B cells in follicular lymphoma express on their surface?
CD20
What are the 2 type of B cell lymphoma?
- Follicular lymphoma: B cells retain follicular pattern
- Diffuse large B cell lymphoma: B cells take over the lymph node in a diffuse pattern
What treatment straetgies are used in treating lymphoma?
- chemotherapy
- radiotherapy
- monocloncal antibody therapy
- emerging new targeted therapy
- stem cell transplant
What monoclonal antibody can be used to treat lymphoma?
Rituximab
How does Rituximab work?
Rituximab targets CD20 protein on B lymphocytes
Causes apoptosis
What are some of the side effects of monoclonal antibodies?
- some have no/ mild symptoms e.g. mild fatigue
- many have mild reaction to 1st treatment then tolerate subsequent treatments well
- Few will have severe infusion related reactions as immune system reacts to presence of foreign protein
- hyperventilation
- nausea and vomiting
- rigor
- back pain
How do you proceed if someone has an infusion related reaction?
What monoclonal antibodies are used in treating solid cancers?
- Trastuzumab - inhibits HER-2 signalling
- Bevacizumab - inhibits VEF-F signalling
- Nivolumumab- inhibits CTLA-4 signalling in Hodgkin Lymphoma
What monoclonal antibodies are used to treat autoimmune conditions?
Infliximab and Adalimumab - inhibit TNF-alpha
