Therapy with immunoglobulin: applications for monoclonal antibodies

Novel anti-CD20 antibody TGLA with enhanced antibody-dependent cell-mediated cytotoxicity mediates potent anti-lymphoma activity

Rituximab is the first anti-cancer antibody approved by the FDA for the treatment of B-cell lymphoma. However, its efficacy remains variable and often modest. Some patients are initially unresponsive to rituximab or later develop resistance to it, and require alternative therapies. Rituximab activity has been thought to involve antibody-dependent cellular cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC) and apoptosis. Present studies suggest that the patients unresponsive to rituximab may be helped with other CD20 antibodies with enhanced activities. In this study, we characterized a novel anti-CD20 chimeric antibody, TGLA, which binds to various B-cell lines specially and shares an epitope with rituximab. TGLA shows equal activities with rituximab, such as CDC, cell growth arrest and so on. Interestingly, TGLA also shows significant ADCC activity. Immunotherapeutic studies further show that TGLA is far more effective in delaying tumor growth than rituximab. These findings suggest that the ADCC-enhanced anti-CD20 antibody TGLA might be an alternative therapeutic agent for B-cell lymphoma.

Infectious complications associated with monoclonal antibodies and related small molecules

Biologics are increasingly becoming part of routine disease management. As more agents are developed, the challenge of keeping track of indications and side effects is growing. While biologics represent a milestone in targeted and specific therapy, they are not without drawbacks, and the judicious use of these "magic bullets" is essential if their full potential is to be realized. Infectious complications in particular are not an uncommon side effect of therapy, whether as a direct consequence of the agent or because of the underlying disease process. With this in mind, we have reviewed and summarized the risks of infection and the infectious disease-related complications for all FDA-approved monoclonal antibodies and some related small molecules, and we discuss the probable mechanisms involved in immunosuppression as well as recommendations for prophylaxis and treatment of specific disease entities.

Antibody based target tailored antimicrobial chemotherapy - a new approach

Ever since antimicrobial therapy was introduced, two phenomenons have been observed: drug resistance and host toxicity. Mutation(s) in microbes leads to the earlier, while off target effects of therapy cause the latter. Neither of these problems have yet to be resolved. All Microbes express specific antigens, against which monoclonal antibodies can be generated ex vivo. If these specific antibodies are conjugated with antimicrobial drugs, it would lead to an increase in the specificity of antimicrobial chemotherapy agents. Moreover, the antibodies also work as anti-infective agents by directing the human immune response to the pathogen. As a result, antibody conjugated antimicrobial chemotherapy may have lower side effects, higher potency and efficacy.