Monoclonal Antibodies: What to Know
- Monoclonal antibody drugs are targeted treatments currently used for certain cancers, including brain, breast, lung, prostate.
- Now, it’s being developed for use in COVID-19 patients; the President took Regeneron’s version in development.
- Antibodies are part of the immune system that circulate in the blood that help fight bacteria and viruses.
Now, suddenly, this type of therapy is getting a star-turn in the press as it's been used on the highest-profile patient on the planet, the President of the United States. Donald Trump received a dose being developed by the drug maker Regeneron, as part of his treatment protocol.
Read MoreWhat Is a Monoclonal Antibody?
The immune system works to knock out diseases, like bacteria and viruses. It may also target abnormal cells, like cancer cells. One of the players in this system of natural defenses is antibodies. Monoclonal antibodies, produced in a lab, are molecules that are engineered to act like the body's natural antibodies, working in support of the immune system.Should Initial Treatment Include Monoclonal Antibodies?
They attach to antigens, and serve as a signal to call for other disease-fighting molecules to come help out, or for the immune system to knock out the bad cells in another way. In other words, monoclonal antibodies help teach the body’s own immune system to target them like they would any other infection.
With monoclonal antibody treatment, “What we’re trying to do is recreate what would happen after someone is infected,” Jones-Lopez tells SurvivorNet. “When someone develops an infection and then becomes immune as a result of that infection, they have in essence built antibodies. In some of those antibodies, you can actually show which ones are the most effective against the pathogen itself. Once you identify that, then you can go to your lab and artificially generate a high concentration of those very particular antibodies.”
Monoclonal Antibody Therapy for COVID-19
At this point, there are no approved treatments for COVID-19, and the president had to receive compassionate-use authorization to use a drug not yet approved by the Food and Drug Administration. But there’s a lot of optimism around Regeneron’s treatment as well as another antibody therapy being developed by Eli Lilly; both are in the worldwide testing phase.
So far, results suggest these drugs can reduce the level of the virus in the body and reduce the amount of time a COVID patient needs to spend in the hospital when they are administered early in the disease.
“It’s been used for some time in cancer, and it’s really the same principle” for COVID, Jones-Lopez explains. “The system would be to identify a cell marker of some type typically, these are membrane markers and then develop an antibody against the target.”
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In short: “All of them use a similar principle: It's a cocktail of different antibodies and they choose the right mix in the right concentration.”
Potential Side Effects of Monoclonal Antibody Treatment
“Historically speaking, they’ve been shown to be quite safe when we’ve used them for other conditions, Dr. Jones-Lopez tells SurvivorNet. But major side effects are certainly possible.
The first, he says, is an allergic reaction to the antibodies. “This is not a chemical molecule, it’s an entire antibody, somewhat complex molecule that could lead to a serious allergic reaction,” he explains.
Secondly, the drug could theoretically enhance the negative effect of a virus. “It’s something similar to the concern we have with a vaccine, and this would only happen if the patient who’s receiving the antibodies has already generated them,” he says. “It would be the interaction between naturally produced antibodies and how those antibodies would interact with the artificially produced antibodies that are now being introduced. In that interaction, there could be either an allergic reaction or a detrimental reaction, a worsening of the disease or the inflammation.”
Still, the doctor explains, while monoclonal antibody treatment may be new as a way to treat COVID, it has been used for serious infectious diseases, including Ebola, yellow fever, and “really a long list of other things,” he says. Results have been good, and there’s reason for optimism if this therapy is approved for COVID-19.
“Viruses, for some reason, are particularly susceptible to being treated with this approach. The science of trying to produce these antibodies is now pretty much settled,” he says. “It's a multi-step process, it’s somewhat complex, and it requires specialized facilities. But it’s not that difficult to do anymore.”
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