The immune system is an incredible development of our bodies, however it has flaws and those flaws can be costly, resulting in chronic and sometimes terminal illnesses. From allergies to viruses and even cancer. At best they impact quality of life, at worst they can shorten a life expectancy. However, in the midst of all this turmoil there is a possible resolution, the mighty, the tiny, the monoclonal antibody. What is it, and how does it work?
Keywords: Monoclonal Antibody, mAb, moAb, Immune System, antigen, antibody.
What is a mAb and Why We Need Them
There I was another spring had come around, but this time it was a little different for me, my ability to breathe properly was diminished heavily. This breathing disorder caused by inflamed polyps in my sinuses was restricting my ability to be active, to get proper rest, and to live a life without constant inflammation. Out of options and home remedies I finally turned to an ENT specialist who diagnosed me with Samter’s Triad or AERD. After this diagnosis the doctor recommended, I try dupilumab, less than twenty-four hours after the first injection I immediately noticed I could breathe, smell, run, hike, and live the active lifestyle I had enjoyed before. While enjoying this restoration it got me thinking what is a monoclonal antibody and what is it doing inside my body to “magically” change my body? What is a mAb? Why do we need them?
mAb As a Solution
In my search for answers, there was no really easy way to define what a monoclonal antibody is however, I will try to summarize it. Essentially, a mAb is a protein structure made in a laboratory, with the objective to act as an antibody once injected into the body of the patient. As we learned in class, antibodies naturally exist within our bodies and work to detect antigens or foreign materials and pathogens that they can attack. These might be cancerous cells, bacteria, or viruses. Sometimes however, our own antibodies either do not recognize a threat such as with cancer or attack our bodies like with an autoimmune disorder. This is where come in to mAbs help by either stimulating the immune system, suppressing the immune system (Corsiero, E., Jagemann, L., Bombardieri, M., & Pitzalis, C., 2018), or working with natural antibodies to help flag the right cells or antigens for destruction (Zahavi, D., & Weiner, L. 2020). This is not all though, the versatility of mAbs in medicine is expanding by the day, and in my case dupilumab helped regulate my immune system response as AERD is caused by a dysregulation within the eosinophils, a type white blood cell, and mast cells both from the immune system, essentially leading to histamine being produced when and where it is not needed causing excess inflammation.
The Downside with mAb
Like every treatment, including ones mentioned in our class such as helminthic treatments or other immunosuppressants, mAb within the body does have its downsides. The first would be the short-term duration of mAb as antibodies do not last very long within the body, this is because they are a form of passive immunity that is introduced to the body so after the antibodies die, they are not replicated within the body in any way. Another downside to weigh when using antibodies can be depending on what type of objective the mAb is treating. In cases like autoimmune disorders, it places the patient at increased risk for infection, or damage from parasites as some mAb treatments work to suppress certain aspects of the immune system normally used to fight bacteria, viruses, and parasites. However, with modern technology we can usually avoid coming into contact with these issues so once more the benefits would need to be weighed by the presumptive end user. Other downsides may include that some monoclonal antibody treatments are experimental. Lastly, they can also be very expensive and not covered by all insurances, which could be a major issue for accessibility, however it should be noted that mAbs are gaining more traction and support from insurance.
mAb in the End
While far from a perfect solution for every problem, I personally believe mAb shows a lot of promise as a futuristic means of treating disorders, diseases, and even cancers by using our natural immune system to boost, suppress, or direct existing and introduced antibodies to attack antigens within our bodies. Hopefully this small insight into a growing world of medicine will increase your desire to learn more about monoclonal antibodies, how they work, and why we need them. I am also continuing my mAb treatment with great success and look forward to seeing its effects in myself and others I know with varying medical concerns.
Corsiero, E., Jagemann, L., Bombardieri, M., & Pitzalis, C. (2018). Generation of Recombinant Monoclonal Antibodies from Single B Cells Isolated from Synovial Tissue of Rheumatoid Arthritis Patients. Methods in Molecular Biology (Clifton, N.J.), 1845, 159–187. https://doi.org/10.1007/978-1-4939-8709-2_10
Zahavi, D., & Weiner, L. (2020). Monoclonal Antibodies in Cancer Therapy. Antibodies (2073-4468), 9(3), 34. https://doi.org/10.3390/antib9030034
Monoclonal antibodies: Definition & How Treatment Works. Cleveland Clinic. (2021, November 16). Retrieved July 22, 2022, from https://my.clevelandclinic.org/health/treatments/22246-monoclonal-antibodies
Monoclonal Antibodies are proteins manufactured in a lab that can help a person’s immune system recognize and fight specific diseases. In this image, you can see the Monoclonal Antibodies attaching to a SARS-CoV-2 virus, binding its attachment points so the virus attaches to human immune cells or white blood cells. These white blood cells can then naturally work to destroy or kill the virus instead of it infecting other cells. The Monoclonal Antibodies shown are specifically engineered to attach to the SARS-CoV-2 virus, but since it is a treatment for an active infection it does not create a memory for future recognition of the virus. Also, treatment of Monoclonal Antibodies will only be effective for as long as injections are continued, but the proteins will expire and immunity to SARS-CoV-2 will not continue beyond continued treatment. Monoclonal Antibodies are a treatment that can be modified for a plethora of diseases, not just SARS-CoV-2. The Monoclonal Antibodies can be proteins that are designed to target an immune response towards an issue as seen in this image or also by suppressing the immune system or helping natural antibodies to target the appropriate cells that need to be marked for destruction. In essence, Monoclonal Antibodies are a promising development in the practitioner world of medicine to treat any issue ranging from cancers to Multiple Sclerosis to viruses.