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Immunology > Session 4: Monoclonal Antibodies > Flashcards

Session 4: Monoclonal Antibodies Flashcards

1
Q

When can monoclonal antibodies be used?

A

In diagnostics

In therapeutics

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2
Q

Give diagnostic uses of monoclonal antibodies.

A

Western blot

Immunofluorescence

Pregnancy test

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3
Q

What is a monoclonal antibody?

A

An antibody that only recognise a specific single antigen

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4
Q

Give therapeutic uses of monoclonal antibodies.

A

Anti-inflammatory vs RA and Crohn’s etc…

Anti-cancer

Anti-viral

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5
Q

Explain the production of monoclonal antibodies.

A

Produced from a single B-lymphocyte clone.

It began to be done via hybridoma technique.

The hybridoma technique involves immunising a certain species against a specific epitope on an antigen. They then harvested the B-lymphocyte from the spleen of the mouse.

B-lymphocyte is then fused with an immortal myeloma that is not containing any immunoglobulin-producing cells.

The result is a hybridoma cell which will start making a specific desired clonal antibody.

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6
Q

What categories of monoclonal antibodies are there?

A

Naked monoclonal antibody

Conjugated monoclonal antibody

Bispecific monoclonal antibody

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7
Q

Give examples of monoclonal antibodies and how humanised they are.

A

Murine (0% human)

Chimeric (65% human)

Humanized (90% human)

Fully human (100% human)

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8
Q

Suffix of murine monoclonal antibody

A

-omab

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9
Q

Suffix of chimeric monoclonal antibody

A

-ximab

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10
Q

Suffix of humanized monoclonal antibody

A

-zumab

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11
Q

Suffix of fully human monoclonal antibody

A

-umab

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12
Q

Why is it important to note how human the monoclonal antibody is?

A

Because of their potential of immunogenicity.

A less human monoclonal antibody has a higher risk of causing an immunological response that is unfavourable.

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13
Q

Explain how monoclonal antibodies can work.

A

Binding with cell surface receptors to either activate or inhibit signalling within the cell

They can bind to induce cell death

Internalisation for antibodies delivering toxins into cancer cells.

Blocking inhibitory effects on T cells (immune checkpoints) - leading to activation of T cells to help kill the cancer cells.

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14
Q

Monoclonal antibodies can bind to cell surface receptors to activate what?

A

Antibody-dependent cell-mediated cytotoxicity (ADCC)

Complement-dependent cytotoxicity (CDC)

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15
Q

What types of lymphomas are there?

A

B cell neoplasms

T cell neoplasms

This is clonal proliferations of lymphoid cells.

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16
Q

Clinical presentation of lymphoma

A

Enlargement of lymph nodes

Night sweats

Fevers

Weight loss

17
Q

Extra-nodal metastases of lymphoma

A

Spleen

Bone marrow

Liver

Skin

Testes

Bowel

18
Q

What is a follicular lymphoma?

A

Small clonal B lymphocytes

19
Q

What is a diffuse large B cell lymphoma?

A

Larger clonal B lymphocytes which take over the node in a diffuse pattern.

20
Q

What will follicular lymphoma and diffuse large B cell lymphoma express?

A

CD20

21
Q

Treatment strategies in lymphoma

A

Chemotherapy

Radiotherapy

Monoclonal antibody therapy

22
Q

What is a normal treatment regiment in lymphoma expressing CD20.

A

Chemotherapy

Steroids

And rituximab

23
Q

Why is rituximab given in diffuse large B cell lymphoma and follicular lymphoma?

A

Because rituximab is a monoclonal antibody vs CD20.

24
Q

Side effects of monoclonal antibodies.

A

No to mild symptoms like fatigue

Some have a mild reaction to the 1st infusion and then tolerate the subsequent treatments well.

Few people will have severe infusion related reactions as their immune system reacts to the presence of a ‘foreign’ protein.

25
Q

How do you prevent severe infusion reactions?

A

Patient education

Instruct patients to omit their anti-hypertension medication 12 hours prior to their infusion.

Pre-medication with steroids, anti-histamine and paracetamol to combat the immunological response and any potential fever.

Start at a slow infusion rate and then slowly increase if tolerated.

26
Q

Give examples of monoclonal antibodies used in solid cancer.

A

Trastuzumab

Bevacizumab

Nivolumab

27
Q

Give example of monoclonal antibodies used in autoimmune conditions.

A

Infliximab

Adalimumab

28
Q

Give examples of monoclonal antibodies in cardiology

A

Abciximab

29
Q

Give examples of monoclonal antibodies in endocrine.

A

Denosumab

30
Q

Action of trastuzumab.

A

Inhibition of HER-2 signalling

31
Q

Action of bevacizumab.

A

Inhibition of VEG-F signalling

32
Q

Action of nivolumab.

A

Inhibition of PD-1 signalling

33
Q

When is adalimumab used?

A

Can be used in Crohn’s

34
Q

Action of infliximab and adalimumab.

A

Inhibition of TNF-alpha

35
Q

Action of abciximab.

A

Inhibition of platelet glycoprotein IIb/IIIa

36
Q
A

Immunology (6 decks)

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