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Volume 2, Number 3—July 1996

Synopsis

Antibody-Based Therapies for Emerging Infectious Diseases

Arturo CasadevallComments to Author 
Author affiliation: Albert Einstein College of Medicine, Bronx, New York, USA

Main Article

Table 1

Serum therapy, human MAbs, and antimicrobial chemotherapy

Antibody therapy
Chemotherapy Comment
Immune serum Human MAb
Specificity Narrow Narrow Broad Narrow specificity avoids selection of resistant organims among nontargeted microbes.
Narrow specificity requires a precise diagnosis before use.
Source Animals
Humans Tissue culture
Bioreactor
Fermentation Fermentation
Chemical
synthesis Before antibiotics, most serum preparations were from horses and rabbits. MAbs are produced by tissue culture techniques.
Industrial production of MAbs may utilize immunoglobulin synthesis in yeast, bacteria, or plants.
Toxicity High Low Low Toxicity of serum was due to allergic reactions to animals protein. Human immunoglobulin preparations are well tolerated (42). Antiidiotypic responses remain a problem for humanized MAb therapy.
Cost High High Low Serum therapy for pneumococcal pneumonia in the 1930s was costly (6). Immunoglobulin therapy remains very expensive.
Administration Difficult Easy Easy Serum therapy required considerable expertise, and because of life-threatening allergic reactions, dosage was often based on clinical experience.
Pharmacokinetics Variable Consistent Consistent Pharmacokinetics of hererologous polyclonal antibody depends on multiple variables, e.g., animal source, isotype composition, and immune status of the recipient.
Human MAbs are homogeneous reagents and can be expected to have more consistent pharmacokinetics.
Mechanism
of action Antimicrobia
Immune
enhancement
Toxin neutralization Antimicrobial
Immune
enhancement
Toxin neutralization Antimicrobial Conventional antimicrobial chemotherapy kills or inhibits the replication of microorganisms. Antibodies function through a variety of mechanisms, e.g., promoting complement-mediated lysis, enhancing antimicrobial efficacy of host effector cells, promoting phagocytosis, preventing attachment, and neutralizing toxins.

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