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What are monoclonal antibodies?

Monoclonal antibodies are one of the most promising processes for the future of medical science. Monoclonal antibody treatments are changing the way doctors approach severe diseases, from cancer to inflammatory diseases and even to treat covid-19. Furthermore, biochemical research and the development of new therapies are made more efficient with the use of molecular antibodies.

 

What is a monoclonal antibody?

Like all antibodies, monoclonal antibodies are proteins used by the immune system to suppress foreign bodies that may be harmful, such as viruses and pathogenic bacteria. 

Monoclonal antibodies are different from common antibodies because they are man-made. They are produced by cloning unique white blood cells. The “-clonal” suffix in the word monoclonal refers to the fact that monoclonal antibodies are clones. “Monoclonal” means that the antibodies are all created from a single origin.

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What is the difference between monoclonal antibodies and polyclonal antibodies?

Both polyclonal and monoclonal antibodies share a common origin and have a similar purpose. The difference between the proteins is that monoclonal antibodies are secreted from a single B cell lineage, while polyclonal antibodies are secreted by different lineages.

 

What are monoclonal antibodies made of?

Monoclonal antibodies are proteins created by cloning white blood cells of the lymphocyte subtype, known as B cells or B lymphocytes. This makes monoclonal antibodies exact copies of the antibody they’re created from.

 

How are monoclonal antibodies used?

Monoclonal antibodies are used in the healthcare industry to detect and treat diseases. Due to monoclonal antibodies’ ability to bind to a large variety of substances, they can be used to enhance the body’s immune response. Likewise, they are also useful tools in biochemistry and molecular biology.

 

Main uses of monoclonal antibodies

Not only can monoclonal antibodies be used to treat diseases, but they are also useful to improve the efficiency of the scientific research intended to create new treatments and medicines. The most common uses of monoclonal antibodies include:

  • Diagnosis and treatment of diseases
  • During organ transplants, such as renal transplants, monoclonal antibodies can be used to type tissue and blood.
  • To detect particular substances. This is useful in a laboratory setting in addition to being convenient in the development of home-testing kits, like covid-19 and pregnancy tests.

 

How monoclonal antibody treatments work

The most common method of administering monoclonal antibodies is via an IV infusion. Monoclonal antibody treatments are often performed at infusion centers, and several people can be treated using this method simultaneously.

Pediatric patients and people undergoing monoclonal antibody therapy for the first time should be accompanied by another person who can help them better understand the procedure. First-time patients will also be screened for severe allergic reactions by health care providers.

It is also possible for patients to be prescribed monoclonal antibody therapy with the use of a subcutaneous injection. Delivery of the drug by use of this method is often done on the abdomen or upper thigh, and patients are taught how to give themselves a shot. 

 

Monoclonal antibodies as a treatment for covid-19

People who have tested positive for covid-19 may be able to undergo monoclonal antibody treatment. This approach can prevent covid-19 patients’ bodies from developing more severe covid-19 symptoms. 

Infusion of covid-19 monoclonal antibodies takes between 1 to 3 hours. The time of infusion can be reduced if a patient is offered the treatment as a series of shots. The patient may also be asked by health care providers to stay in the premises for another hour after the infusion, to screen them for allergic reactions and other adverse effects. Even if these side effects are rare, being close to a medical team is advantageous.

Since monoclonal antibody treatments contain no live virus material, it is impossible to acquire a viral pathogen from this type of therapy. Therefore, people undergoing treatment using covid-19 monoclonal antibodies are at no risk of being infected with the disease from the treatment. People who have tested positive for covid-19, however, can still spread the disease for a while after monoclonal antibody therapy.

A study published by Open Forum Infectious Diseases found that high-risk patients of covid-19 who used the drug Bamlanivimab showed fewer hospital admissions and a lower mortality rate (source). By using the drug, patients experienced a hospitalization rate of 6.4%, less than half of patients who weren’t administered the drug. The drug’s effects were more noticeable in patients over 65 years of age.

 

What types of diseases do monoclonal antibodies treat?

Monoclonal antibody treatments can be used to tend to a large variety of conditions, and their use is becoming more common as new therapies are developed. The use of monoclonal antibodies has been approved to treat covid-19, cancer, inflammatory diseases, and many other ailments.

 

Conditions that can be treated using monoclonal antibodies include: 

  • Cancer
  • Inflammatory diseases like Crohn’s disease
  • Moderate covid-19 symptoms
  • Moderate-to-severe allergic asthma
  • Cardiovascular disease
  • Eye conditions, such as age-related macular degeneration
  • Osteoporosis
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Nervous system disorders
  • Ulcerative colitis
  • Multiple sclerosis
  • Psoriasis
  • Migraines

 

How do monoclonal antibody drugs work?

Monoclonal antibodies stimulate the body’s immune system by targeting pathogens directly and triggering other immune response effects. This means that a monoclonal antibody drug may have been designed to perform two or more different functions. 

 

For example, monoclonal antibodies designed to treat cancer can have the following effects on the body: 

  • Flag cancerous cells: Monoclonal antibodies can bind themselves to diseased cells, allowing the immune system to accurately find them and eliminate them.
  • Trigger cell membrane destruction: The outer membrane of cancer cells can be attacked by using monoclonal antibodies to trigger the body’s immune response.
  • Block cancer cell growth: The connection between cancer cells and proteins that promote cell growth can be severed by monoclonal antibodies. Likewise, the development of blood vessels in cancerous tumors can also be halted by blocking protein-cell interactions. 
  •  Block immune system inhibitors: The body uses immune system inhibitors to prevent immune system cells from being overactive. Monoclonal antibodies can prevent these inhibitors from fulfilling their function, causing human cells to act more aggressively towards cancer cells.
  • Delivering other treatments: The usefulness of monoclonal antibodies lies in their ability to bind to other substances. Therefore, they can be engineered to transport other treatments directly to where they are needed on the body. This approach can be used for more precise chemotherapy, as well as for radiation treatment.
  • Binding cells: Monoclonal antibodies can also be used to bind cancer and specific immune system cells. Once they’re bound, it will be easier for immune systems cells to react to cancer.

 

What are the advantages of using monoclonal antibodies?

A major benefit of monoclonal antibody treatments is precision. Monoclonal antibodies are more accurate than other treatments at detecting pathogens, leading to more effective treatments and a reduced chance of side effects. 

Thanks to recent advancements in technology, medication based on monoclonal antibodies can be produced in large quantities. This gives a promising outlook on the future of monoclonal antibody products. Monoclonal antibody treatments have proven to be more effective at treating certain severe diseases, such as cancer, than previous approaches.

 

What types of side effects do monoclonal antibody drugs cause?

A monoclonal antibody infusion may cause a patient to experience certain adverse reactions. Normally, this is due to a person’s strong immune response to monoclonal antibodies. In case side effects were to present themselves, their reaction can be limited by decreasing the dose or by slowing down the infusion.

Common reactions that may happen during or soon after treatment include:

  • Sweating
  • Fever
  • Chills
  • Rigor
  • Shortness of breath
  • Increased heart rate
  • Changes in blood pressure
  • Developing a rash

 

Depending on the condition being treated and the monoclonal antibody drugs being used, a patient might also develop the following side effects: 

  • Dizziness
  • Headaches
  • An allergic reaction
  • Diarrhea
  • Constipation
  • Back pain
  • Loss of appetite
  • Insomnia
  • A general feeling of weakness

 

It is possible, but highly uncommon, that a patient experiences more severe side effects. These reactions can be caused by unwanted immune system responses. Potential risks of monoclonal antibody therapy can be linked to the disease being treated. An example of this phenomenon is kidney failure due to the tumor lysis syndrome, a possible side effect of cancer treatments.  

 

An unwanted immune response to monoclonal antibodies can cause the following conditions:

  • Anaphylaxis
  • Arterial and venous blood clots
  • Serum sickness
  • Autoimmune thyroiditis
  • Hypothyroidism
  • Heart failure
  • Bleeding
  • Anemia
  • Inflammatory diseases
  • Cancer
  • Reducing the bodies’ natural immune response
  • Reducing the number of white blood cells

 

What should you consider when deciding on monoclonal antibody drug treatment?

The best course of action when approaching treatment is to discuss the options available to you with your healthcare provider. By letting a health professional clear your doubts, you will be better equipped to understand the pros and cons of monoclonal antibody treatments.

 

When talking to your doctor, you may want to discuss the following relevant topics:

  • The effectiveness of a particular monoclonal antibody drug: If you have a medical condition that has a monoclonal antibody treatment available, you should ask about any evidence of its effects in studies and clinical trials. You should also ask if the therapy is the first-line treatment for the condition, or if it is considered to be an alternative to other treatment options. 
  • Are there any side effects?: Potential risks of using monoclonal antibodies are highly dependent on the type of drug being used. Health care providers can help you determine whether a monoclonal antibody treatment’s potential benefits outweigh the risks.
  • Costs of monoclonal antibody therapy: Monoclonal antibodies are in high demand. For instance, many people are seeking to use monoclonal antibodies after they test positive for covid-19. However, monoclonal antibody treatments can be very expensive. You should talk to your doctor about their affordability, including any administrative costs that may be associated with the treatment.
  • Undergoing clinical trials for monoclonal antibody treatments: Clinical trials are a particular type of study where the effectiveness of treatments is put to the test. Participating in clinical trials will allow a patient to have access to monoclonal antibody therapy. Your doctor may be able to assess whether or not you could be a potential participant in clinical trials.

 

Monoclonal antibody testing