Session 4: Monoclonal Antibodies Flashcards
When can monoclonal antibodies be used?
In diagnostics
In therapeutics
Give diagnostic uses of monoclonal antibodies.
Western blot
Immunofluorescence
Pregnancy test
What is a monoclonal antibody?
An antibody that only recognise a specific single antigen
Give therapeutic uses of monoclonal antibodies.
Anti-inflammatory vs RA and Crohn’s etc…
Anti-cancer
Anti-viral
Explain the production of monoclonal antibodies.
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.
What categories of monoclonal antibodies are there?
Naked monoclonal antibody
Conjugated monoclonal antibody
Bispecific monoclonal antibody
Give examples of monoclonal antibodies and how humanised they are.
Murine (0% human)
Chimeric (65% human)
Humanized (90% human)
Fully human (100% human)
Suffix of murine monoclonal antibody
-omab
Suffix of chimeric monoclonal antibody
-ximab
Suffix of humanized monoclonal antibody
-zumab
Suffix of fully human monoclonal antibody
-umab
Why is it important to note how human the monoclonal antibody is?
Because of their potential of immunogenicity.
A less human monoclonal antibody has a higher risk of causing an immunological response that is unfavourable.
Explain how monoclonal antibodies can work.
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.
Monoclonal antibodies can bind to cell surface receptors to activate what?
Antibody-dependent cell-mediated cytotoxicity (ADCC)
Complement-dependent cytotoxicity (CDC)
What types of lymphomas are there?
B cell neoplasms
T cell neoplasms
This is clonal proliferations of lymphoid cells.
Clinical presentation of lymphoma
Enlargement of lymph nodes
Night sweats
Fevers
Weight loss
Extra-nodal metastases of lymphoma
Spleen
Bone marrow
Liver
Skin
Testes
Bowel
What is a follicular lymphoma?
Small clonal B lymphocytes
What is a diffuse large B cell lymphoma?
Larger clonal B lymphocytes which take over the node in a diffuse pattern.
What will follicular lymphoma and diffuse large B cell lymphoma express?
CD20
Treatment strategies in lymphoma
Chemotherapy
Radiotherapy
Monoclonal antibody therapy
What is a normal treatment regiment in lymphoma expressing CD20.
Chemotherapy
Steroids
And rituximab
Why is rituximab given in diffuse large B cell lymphoma and follicular lymphoma?
Because rituximab is a monoclonal antibody vs CD20.
Side effects of monoclonal antibodies.
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.
