Volume 2, Number 3—July 1996
Antibody-Based Therapies for Emerging Infectious Diseases
|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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