Immunotherapy for Infectious Diseases

Production of Immunoglobulins and Monoclonal
Antibodies Targeting Infectious Diseases
Renate Kunert and Hermann Katinger
INTRODUCTION
Infectious and parasitic diseases have been the major cause of death over the last
centuries in developing countries. Similarly, in the past, viral and bacterial infections
have killed tens of thousands of people in the large cities of Europe. The first success
in overcoming the mortality related to infectious diseases was derived from observations
that the serum from cows infected with smallpox protected against human
poxviruses. In 1800, Jenner was the first to apply experimental inoculations of cowpox
to human volunteers. Vaccination against smallpox, beginning in the 19th century,
quickly restricted the disease in Europe and North America.
The basis of immunotherapy was established in Berlin at the Robert Koch Institute
of Hygiene. In 1890, Emil von Behring and Shibasabura Kitasato published a landmark
article showing that serum from actively immunized animals could neutralize toxic
concentrations of toxin in other animals. They could also successfully cure children of
diphtheria with horse antisera. Serotherapy was established as a treatment against diphtheria
as well as tetanus toxin.
After the principles of serotherapy were evident the doors were open for further
applications. The major problem arising from this first generation of passive serotherapy
was anaphylactoid reaction. Stepwise technologic improvements such as precipitation
of the immunoglobulins from sera reduced these problems. The �-globulins are
now a group of safe drugs that are prepared from either healthy donors, vaccinated volunteers,
or even reconvalescent donors by applying sophisticated manufacturing technologies.
Both basic research and broad clinical applications of immunoglobulins over
decades have provided us with a good knowledge base for technologic and application
improvements. The advantages of antibody-based prevention strategies and therapies
include versatility, low toxicity, pathogen specificity, enhancement of immune function,
and favorable pharmacokinetics; the disadvantages include high cost, limited usefulness
against mixed infections, and the need for early and precise microbiologic diagnosis
(1). Hospital infections and resistance to antibiotics generate serious problems
that need to be solved. The combination of antibody therapy with other therapeutic
drugs is still a widely unexplored field of new forms of treatment (2).
From: Immunotherapy for Infectious Diseases
Edited by: J. M. Jacobson © Humana Press Inc., Totowa, NJ
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