Keywords
Mouse monoclonal antibody · Chimeric antibody · Humanized antibody · Human
antibody · Therapeutic applications of monoclonal antibody
22.1
Introduction
Production of monoclonal antibodies (MAbs) has evolved since the first demonstra-
tion by Köhler and Milstein at Medical Research Council (MRC), Cambridge, UK,
about the feasibility to obtain hybrid cell clones capable of growing in culture and
secreting antibodies of predefined specificity by somatic cell hybridization (Köhler
and Milstein 1975). For this discovery, Cesar Milstein and George J. F. Köhler won
the Noble Prize in Physiology or Medicine in 1984 along with Niels K. Jerne. The
MRC, UK, awarded its first Millennium Medal to Cesar Milstein in 2000 in
recognition of his groundbreaking work, and its Chief Executive Professor Sir
George
Radda
commented
that
“the
discovery
of
monoclonal
antibodies
revolutionized biomedical research and sparked an international billion-pound bio-
technology industry. No other MRC scientist has made such an outstanding contri-
bution to Britain’s science, health and wealth creation” (The Times, London,
26 March 2002, Obituaries-Cesar Milstein). MAbs are homogeneous in nature and
can be produced in large amounts. Due to the high specificity of MAbs, these are
useful in targeting tumor cells and microbial pathogens. These can be used as either
stand-alone or adjunct therapy in conjunction with the conventional therapy. In
cancer patients as compared to radiation and chemotherapy, immunotherapy by
MAbs may have less side effects. Furthermore, therapeutic MAbs are also useful
for immunocompromised hosts, elderly persons, and pregnant women. The first
murine MAb OKT3™that recognizes a nonpolymorphic subunit of human T cell
receptor, CD3, was approved by the US Food and Drug Administration (FDA) for
use in human subjects to prevent rejection of renal allografts (Chatenoud 2003). In
addition, mouse MAb generated against CD20 on B cell was also used in patients
suffering from non-Hodgkin’s lymphoma. Though murine antibodies have exquisite
specificity for therapeutic targets, they do not always trigger appropriate human
effector functions of complement and Fc receptor. Further, murine antibodies are
recognized as foreign by the human immune system evoking human anti-murine
antibody immune response, thus cutting short their therapeutic window (Shawler
et al. 1985). However, limitations in the use of murine MAbs for therapeutic
applications can be overcome by using newer protein engineering and molecular
biology tools and advances in cell biology to develop more human-like MAbs with
lesser immunogenicity. Evolution of the therapeutic MAbs is schematically shown
in Fig. 22.1. In this chapter, we will briefly describe the strategies to produce
chimeric, humanized, and human MAbs and their therapeutic applications. In
addition, novel MAb variants and their potential application will also be discussed.
The current and forecasted market of therapeutic MAbs will also be presented.
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S. K. Gupta and P. Chaudhary