Lec 4- Antibody therapies Flashcards

1
Q

What are antibodies

A
  • Antibodies (also known as immunoglobulins) are large, complex protein macromolecules
  • They are produced by the adaptive immune systems to recognise and specifically target foreign materials, known as Ag
  • Ab’s are produced by B cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of Antibodies

A
  • Antibodies generally comprise of the following structural elements
    • 2 large heavy polypeptide chains (50,000 molecular weight)
    • 2 small light chains (23,000 MW)
  • There are several classes (isotypes) of Ab’s produced in the human body
    • 5 main types: IgG, A, M, E, D
  • There are classed based on their heavy chain and perform different roles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Antibodies Isotypes

A
  • Of these, IgG is the most abundant and most of the currently approved anti-body based drugs are of the IgG class
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diagnostic testing of your knowledge: Figure of IgG Ab

A
  • The lower portion of Y is the heavy chain
  • Arms make the light chain
  • Tips are the variable region which gives the Ig Ab specificity for Ag binding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Antibody structure

A
  • These chains are held together by non-covalent binding and disulfide bonds
  • The specificity of a given Ab is determined by the amino acid sequence located at the end of it’s Fab region
  • By employing cloned immune cells to obtain antibodies, single specificity antibodies referred to as mAb can be produced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are polyclonal Ab preparations

A
  • Polyclonal Abs are derived from different B cell lines
  • They are a mixture of Ab’s secreted against a specific Ag, each recognising a different epitope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Polyclonals

A
  • Maybe categorized into groups based on their target specificities
    • Ab’s raised against
      • Specific microbial or viral pathogens
      • Micro toxins
      • Snake/spider venom (Anti-venoms)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Polyclonal Ab’s

A
  • Antibodies are produced by immunising healthy animals (e.g. horse) or humans with appropriate antigen. Blood is harvested and the antibodies extracted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Monoclonal Antibodies (mAbs)

A
  • mAbs are the most widely used form of cancer immunotherapy at this time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Development of antibody-based therapies

A
  • The main concerns are
    1. Developing mAb’s of appropriate specificity and affinity
    2. Engaging an appropriate mechanism (Drug action and tagging)
    3. Suitable PK
    4. Avoiding host immune response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Murine, chimeric or humanised Abs

A
  • First mAbs were made entirely of mouse cells
  • Problems: Immune response against them
    • Allergic-type reactions
    • Effective first time, but after that they are destroyed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Murine mAbs

A
  • Key advances in the production of monoclonal antibodies have supported their increased application including the improved ability to produce appropriate quantities of pure antibodies and more importantly the ability to prepare humanized antibodies
  • Prior to this, the use of murine based Ab therapeutics (e.g. OKT-3, muromonab-CD3, approved for use within the US) resulted in antibody therapies generally being limited to acute, single treatments such as tissue rejection after a kidney transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Developments

A
  • The use of murine antibodies often results in the patient’s immune system inducing human anti-mouse Ab’s that can lead to lack of efficacy, rapid clearance of the Ab, adverse reactions to the antibody and often reduced the efficacy
  • Recombinant technologies have supported the production of less immunogenic mAbs
    • Chimeric Ab’s are composed of murine variable regions fused with human constant regions E.g. rituximab
    • Humanised Ab’s are produced by grafting murine hypervariable amino acid domains into human antibodies E.g. trastuzumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Human mAb’s

A
  • Complete human mAb constructs can now also be produced due to developments in phage display technology and transgenic mic
    • E.g. adalimumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chimeric or humanized

A
  • Depends on how much of the mAb is human
  • The more human the more likely they will be safe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Antibodies as drugs

A
  • Due to their targeting properties, mAbs can be used as targeted drugs in their own right or as targeting carriers by linking a drug covalently or non-covalently to them
  • As therapeutics agents, there are several antibodies based therapies clinically used
17
Q

How do they work

A
  • Their ability to recognise and bind to a given antigen allows them to bind to particular proteins/antigens on a cell surface
  • The formation of such complexes can result in the receptor action being down-regulated and or blocked or stimulate the recognition and destruction of cells by the host immune system
18
Q

Clinical application of mAb

A
  • Induction of passive immunisation
  • Diagnostic imaging
  • Therapy for cancers, transplantations and cardiovascular disease
19
Q

Two types of mAbs

A
  • Two types of mAbs are used in cancer treatments
    • Naked monoclonal antibodies- No drug or radioactive material attached to them
    • Conjugated monoclonal antibodies- mAb joined to a chemotherapeutic drug, radioactive substance or a toxin
20
Q

How do they work

A
21
Q

Naked mAbs

A
  • These are the most commonly used
  • All attach themselves to specific antigens
  • Different mechanism
  • Act as a marker for the body’s immune system to destroy them
    • E.g. rituximab, alemtuzumab
  • Don’t interact with a person’s own immune system but bind to a specific antigen which are functional parts of cancer cells or helps the cells to grow
    • E.g. Trastuzumab
22
Q

Side effects from naked mAbs

A
  • mAbs are given IV
  • Possible side effects include
    • Fever, chills, weakness, headache, nausea, vomiting, diarrhoea, low BP, rashes
  • These are generally mild compared to chemotherapy
23
Q
A
24
Q
A
25
Q
A
26
Q

Conjugated mAbs

A
  • These have a drug or a marker conjugated to them
  • Radio-labelled examples
    • Ibritumomab tiuxetan
    • Tositumomab
  • There is no chemo-labelled or immunotoxins currently on the market
27
Q

Conjugated mAbs

A
  • This allows for the use of Ab to actively target specific cell types and as targeting groups
  • Ab’s have the advantage of high specificity, due to their Ag recognition and targeting capability
  • However, due to their protein nature, antibodies are subject to a range of purity and instability issues similar to those outlined for proteins carried
28
Q

Antibodies carrier drug conjugate

A
  • Most antibody conjugates have a relatively poor drug-carrying capacity
    • Have a low drug to antibody ratio in the region of 3-10, with higher loading often resulting in reducing antibody binding activity
  • Cumulatively this will limit drug concentration at the site of action
  • Studies on antibody carrier drug conjugates such as antibody-doxorubicin have been conducted but the method is seen to be hindered by it’s increased the complexity