Chapter 17 Immune Modifiers
Systemic Steroids
MOA (Mechanism of Action)
Pharmacokinetics
Side Effects
Important Notes
Advanced
Evidence
Introduction to Monoclonal Antibodies
Newer technologies are enabling the animal (usually mouse) portion of the antibody to be less and less, so that the resulting antibody is mostly human and therefore not destroyed by the patient’s own immune system for being a foreign antibody by human antimurine antibodies (HAMAs). Chimeric (human-mouse combination) antibodies contain fewer mouse regions than full mouse antibodies. Humanization involves replacing most of the mouse antibody with equivalent human regions while keeping only the variable, antigen-specific regions intact. Humanized mAbs have more human regions than chimeric mAbs do. Finally, fully human mAbs that contain no mouse regions are now being created (Figure 17-1).
Fusion Proteins
Use of Monoclonal Antibodies
The list of uses for mAbs is growing, but the major categories are as follows:
Naming Monoclonal Antibodies
Targets
Notes
Table 17-2 will not be fully inclusive by the time it is published because of the rapid growth of this area of medicine. Some drugs listed may not yet be approved for use.
Name | Type | Target |
---|---|---|
Rituximab | Chimeric | CD20 on B lymphocytes |
Ocrelizumab | Humanized | CD20 on B lymphocytes |
Ofatumumab | Human | CD20 on B lymphocytes |
Tositumomab | Mouse |
EGF, epidermal growth factor; HER2, human epidermal growth factor receptor 2; 131I, iodine-131; IgE, immunoglobulin E; IL, interleukin; 111In, indium-111; PSA, prostate-specific antigen; TNF, tumor necrosis factor; 90Y, yttrium-90.
B-Cell Biologics
Description
B-cell biologics specifically target B-cell lymphocytes for either destruction or suppression.
MOA (Mechanism of Action)
Pharmacokinetics
Indications
Contraindications
Side Effects
Early
Important Notes
Advanced
T-Cell Biologics
Description
T-cell biologics specifically target T-cell lymphocytes for either destruction or suppression.