A monoclonal antibody (mAb) is an antibody created in a laboratory and designed to bind to one particular antigen, e.g. found on specific cancer cells or to the spike protein in the coronavirus. This is why monoclonal antibodies can be used as a targeted treatment option for various medical conditions (such as in cancer therapy), as they support the immune system to carry out a desired immune response.
MAbs play a significant role in modern medicine. Several clinical trials are carried out to find new ways for monoclonal antibodies to serve public health, while various treatments are well-established already. Particularly after the emergence of SARS-CoV-2 pandemic and the associated search for COVID-19 vaccines as well as options to treat COVID-19, monoclonal antibodies are not only a hot topic among healthcare providers, but have gained a broader public awareness.
Monoclonal antibody treatments – an overview
As already stated, there is a wide range of monoclonal antibody treatments for often severe diseases – here are a few medical conditions for which mAbs can be chosen for therapeutic purposes:
- immunotherapy with mAbs for various cancer types
- autoimmune diseases and adverse events after transplantations
- asthma
- biochemical analysis
- infectious diseases (also in the treatment of COVID-19)
The treatment of coronavirus infections is one of the most frequent areas of research, considering monoclonal antibodies. In 2020, mAb treatments for COVID-19 were already approved by the U.S. Food and Drug Administration (FDA) via emergency use authorization (EUA).
One important therapeutic against COVID-19 based on monoclonal antibodies is Bebtelovimab. In specific treatment guidelines, the National Institute of Health (NIH) refers to the circumstances under which the product is suitable for administration – e.g. for some high-risk patients (people with individual risk factors for severe COVID-19 symptoms) with a mild to moderate COVID-19 infection where no hospitalization has been effected. Due to the predominance of the Omicron variants, other products, on the other hand, seem to be no longer advisable for usage (e.g. Casirivimab plus Imdevimab, Sotrovimab, or Bamlanivimab plus Etesevimab), which only underlines the quick progress that is made in this field.1
Possible side effects of monoclonal antibody therapy
After monoclonal antibody infusion (mAbs are usually designed for subcutaneous or intravenous application, often performed in outpatient infusion centers), it is possible to experience side effects. Some of the most frequent infusion reactions and side effects of monoclonal antibody therapies are:
- allergic reactions
- diarrhea
- nausea and vomiting
- fever
- low blood pressure
- weakness
- constipation
- cough
Depending on the individual patient and treatment, other side effects are possible and are discussed with the treating doctor, who will also consider reactions in case of the appearance of side effects.
Monoclonal antibody production – different techniques
Considering monoclonal antibody production, several expression methods have been established. Among the most promising approaches in monoclonal antibody production are:
- hybridoma production – hybridoma (a combination of B cells and a myeloma cell) cell lines are generated to produce antibodies
- phage display technology – a monoclonal antibody production method based on bacteria
- single B cell technologies – genetic material suitable for antibody production is searched within B cell lines ex vivo, subsequently used for mAbs production
Difference between polyclonal and monoclonal antibodies
The major difference between polyclonal and monoclonal antibodies lies in their specificity: Monoclonal antibodies are produced by cloning one single antibody, which leads to a higher specificity.
Polyclonal antibodies, on the other hand, are produced within different plasma cell lines. As a consequence, they have a minor binding specificity to a particular antigen.
Monoclonal Antibody production
Application of monoclonal antibodies
Monoclonal versus polyclonal antibodies
- 1.Anti-SARS-CoV-2 Monoclonal Antibodies. NIH. Accessed November 2022. https://www.covid19treatmentguidelines.nih.gov/therapies/anti-sars-cov-2-antibody-products/anti-sars-cov-2-monoclonal-antibodies/