Construction of a Human Immune Library from Gallbladder Cancer Patients for the Single-Chain Fragment Variable (scFv) Antibody Selection against Claudin 18.2 via Phage Display

Gallbladder cancer (GBC) is a very aggressive malignant neoplasm of the biliary tract with a poor prognosis. There are no specific therapies for the treatment of GBC or early diagnosis tools; for this reason, the development of strategies and technologies that facilitate or allow an early diagnosis of GBC continues to be decisive. Phage display is a robust technique used for the production of monoclonal antibodies (mAbs) involving (1) the generation of gene libraries, (2) the screening and selection of isoforms related to an immobilized antigen, and (3) the in vitro maturation of the affinity of the antibody for the antigen. This research aimed to construct a human immune library from PBMCs of GBC patients and the isolation of scFv-phage clones with specificity against the larger extracellular loop belonging to claudin 18.2, which is an important biomarker overexpressed in GBC as well as gastric cancer. The immune-library-denominated GALLBLA1 was constructed from seven GBC patients and has a diversity of 6.12 × 1010pfu mL-1. After three rounds of panning, we were able to identify clones with specificity against claudin 18.2. GALLBLA1 can contribute to the selection, isolation, and recombinant production of new human mAbs candidates for the treatment of gastrointestinal cancers.

Therapeutic Targets of Monoclonal Antibodies Used in the Treatment of Cancer: Current and Emerging

Cancer is one of the leading global causes of death and disease, and treatment options are constantly evolving. In this sense, the use of monoclonal antibodies (mAbs) in immunotherapy has been considered a fundamental aspect of modern cancer therapy. In order to avoid collateral damage, it is indispensable to identify specific molecular targets or biomarkers of therapy and/or diagnosis (theragnostic) when designing an appropriate immunotherapeutic regimen for any type of cancer. Furthermore, it is important to understand the currently employed mAbs in immunotherapy and their mechanisms of action in combating cancer. To achieve this, a comprehensive understanding of the biology of cancer cell antigens, domains, and functions is necessary, including both those presently utilized and those emerging as potential targets for the design of new mAbs in cancer treatment. This review aims to provide a description of the therapeutic targets utilized in cancer immunotherapy over the past 5 years, as well as emerging targets that hold promise as potential therapeutic options in the application of mAbs for immunotherapy. Additionally, the review explores the mechanisms of actin of the currently employed mAbs in immunotherapy.

Consequences of overhydration and the need for dry weight assessment

Despite significant progress in the fields of dialysis technology and medical therapy, mortality of hemodialysis (HD) patients remains high. Chronic overhydration is a major contributor to the high cardiovascular morbidity and mortality observed in HD patients. The difficulty of measuring excess fluid accurately and the determination of 'dry weight' are reflected in the abundant literature on overhydration. Data indicate that a significant proportion of HD patients are not at 'dry weight'. Considering its impact on cardiovascular diseases, the relation between excess fluid, sodium, interdialytic weight gain, hypertension and cardiac diseases needs more attention. Clearly the reduction of sodium intake is of prime importance. This can be achieved by a reduction of dietary sodium intake, individualized dialysate sodium concentration, avoidance of sodium profiling and use of hypertonic saline during dialysis. These measures are expected to result in less thirst and consecutive water intake, thereby facilitating achieving dry weight (DW). In concert, the application of new tools for DW assessment such as continuous intradialytic bioimpedance spectroscopy measurement, means to prevent intradialytic symptoms (e.g. glucose bolus instead of hypertonic saline; improved hemodynamic stability by reduced dialysate temperature) may be operative in reducing morbidity and mortality in HD patients.