monoclonal antibody

monoclonal antibody, antibody produced artificially through genetic engineering and related techniques. Production of monoclonal antibodies was one of the most important techniques of biotechnology to emerge during the last quarter of the 20th century. When activated by an antigen, a circulating B cell multiplies to form a clone of plasma cells, each secreting identical immunoglobulin molecules. It is such immunoglobulins—derived from the descendants of a single B cell—that are called monoclonal antibodies.

The antibody response to a natural infection or an active immunization, however, is polyclonal. In other words, it involves many B cells, each of which recognizes a different antigenic determinant (epitope) of the immunizing antigen and secretes a different immunoglobulin. Thus the blood serum of an immunized person or animal normally contains a mixture of antibodies, all capable of combining with the same antigen but with different epitopes that appear on the surface of the antigen. Furthermore, even antibodies that bind to the same epitope often have different abilities to bind to that epitope. This makes isolating an appreciable quantity of a particular monoclonal antibody from the polyclonal mixture extremely difficult.

Hybridoma

An astonishingly high serum concentration of a single type of immunoglobulin is associated with multiple myeloma, a type of cancer in which a single B cell proliferates to form a tumorous clone of antibody-secreting cells that can multiply indefinitely, like all cancer cells (see immune system disorder: Cancers of the lymphocytes). Thus the immunoglobulins made by myelomas are monoclonal, and myeloma cells have been propagated to produce large quantities of monoclonal antibodies, which have been used to study the basic nature of immunoglobulins. Unfortunately, however, the antigen to which the myeloma antibodies bind is unknown. If an immunologist wanted to obtain large amounts of a particular antibody—say, the anti-Rh antibody—the induction of myelomas is useless, for it has proved impossible to specify beforehand what antibody will be secreted by any given myeloma.

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transplant: Monoclonal antibodies

However, it is possible to produce large amounts of a chosen, identifiable monoclonal antibody (see illustration). Occasionally a cultured myeloma cell line continues to grow well but loses its ability to secrete immunoglobulin. In 1975 the immunologists Georges Köhler and César Milstein fused non-antibody-secreting cultured myeloma cells with normal B cells from the spleen of an immunized mouse. The fusion of a myeloma cell from a line that has lost the ability to secrete immunoglobulin with a B cell known to secrete a particular antibody results in a remarkable hybrid cell that produces the antibody made by its B-cell component but retains the capacity of its myeloma component to multiply indefinitely. Such a hybrid cell is called a hybridoma.

Because of hybridomas, researchers can obtain monoclonal antibodies that recognize individual antigenic sites on almost any molecule, from drugs and hormones to microbial antigens and cell receptors. The exquisite specificity of monoclonal antibodies and their availability in quantity have made it possible to devise sensitive assays for an enormous range of biologically important substances and to distinguish cells from one another by identifying previously unknown marker molecules on their surfaces. For example, monoclonal antibodies that react with cancer antigens can be used to identify cancer cells in tissue samples. Moreover, if short-lived radioactive atoms are added to these antibodies and they are then administered in tiny quantities to a patient, they become attached exclusively to the cancer tissue. By means of instruments that detect the radioactivity, physicians can locate the cancerous sites without surgical intervention. Monoclonal antibodies also have been used experimentally to deliver cytotoxic drugs or radiation to cancer cells.

Human monoclonal antibodies

Although the preparation of monoclonal antibodies from rat or mouse cells has become routine practice, the construction of human hybridomas has not been as easy. This is partly because most human myeloma cells do not grow well in culture, and those that do have not produced stable hybridomas. If, however, human B cells isolated from blood are infected by the Epstein-Barr virus (the agent that causes infectious mononucleosis), they can be propagated in culture, where they continue to secrete immunoglobulin. Very few of them are likely to produce an antibody with a desired specificity, even from a subject who has been immunized; but in some instances immunologists have succeeded in identifying and selecting cells that secrete the wanted immunoglobulin. These cells can be grown in culture as single clones that secrete a monoclonal antibody. Researchers have used this process to obtain human monoclonal antibodies against the Rh antigen.

A simpler method of constructing human monoclonal antibodies can be accomplished using recombinant DNA techniques. Once a mouse monoclonal antibody has been constructed using the traditional methods just described, DNA encoding the antigen-binding portion of the antibody molecule can be isolated and fused to human DNA that encodes an antibody. Then the hybrid DNA is inserted into a bacterium, which produces half-mouse–half-human monoclonal antibodies. The antibodies made by this method are less likely to induce an anti-antibody response when given to humans. Further fine-tuning can be done to change all parts of the antibody that are not directly involved in binding to the specific antigen. This technique has been used to produce a large number of different monoclonal antibodies for use in therapy.

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Human monoclonal antibodies also can be generated using phage display technology. In this approach, human antibody proteins are engineered and expressed on the surfaces of phage (bacteriophage) virion particles. Cultures of fusion phages can then be purified, enriching the amount of fusion protein available for further investigation. Adalimumab was the first fully human monoclonal antibody developed through phage display to be approved for clinical use in human patients; it was approved in 2002 as a therapy for rheumatoid arthritis. An injectable humanized monoclonal antibody is available for prevention of severe respiratory syncytial virus (RSV) in high-risk infants and children.