Immunotherapy for Infectious Diseases
Immunotherapy for Infectious Diseases Immunotherapy for Infectious Diseases
71 Table 2 Summary of Favorable Functions of Antibodies for In Vivo Application Purpose Favorable functions Preferred type of antibody Favorable expression system In vivo imaging of tumors for Specific recognition and binding, Fab, Fv E. coli, yeast, others diagnostic purpose rapid serum clearance Target agent for immunotoxins High specificity, rapid serum Bispecific antibodies or fragments, E. coli, chemical modification. clearance conjugated antibodies Neutralization of toxins after High affinity Fab, or whole antibody E. coli or others accident Prevention of infection Specific recognition of infective IgG, IgA, IgM Mammalian cells as CHO, NSO, target epitopes; also functional BHK, hybridoma in mucosa Treatment of manifest As mentioned before plus: IgG, IgA, IgM Mammalian cells at high infections or diseases; long- neutralization such as expression levels and low term high-dose repeat complement and ADCC, no costs treatment ADE Abbreviations: ADCC, antibody-dependent cellular cytotoxicity; ADE, antibody-dependent enhancement.
72 Kunert and Katinger Fig. 6. Different ways of preserving the humoral immune reaction. EBV, Epstein-Barr virus. anti-Rh-D immunoglobulin has reduced the prevalence of Rh isoimmunization in the United States and Canada by 96% since the 1940s; interestingly, it only received U.S. Food and Drug Administration (FDA) licensing approval in 1968. Hyperimmune sera against different viruses, such as varicella-zoster virus, hepatitis B virus, cytomegalovirus (CMV), and respiratory syncytial virus (RSV) are used either after accidental exposure or to treat high-risk groups, such as immunocompromised patients. Polyclonal human hyperimmunoglobulins are used to prevent lower RSV disease in high-risk children under 24 months of age (12). Theses infants suffer from bronchopulmonary dysplasia or chronic lung disease or have a history of premature birth (13). CMV immunoglobulin is used to attenuate primary CMV disease associated with renal transplantation if CMV-seronegative patients receive a kidney from a CMVseropositive donor. When used prophylactically in renal allograft recipients, CMV-IGIV has been shown to reduce the incidence of virologically confirmed CMV-associated syndromes (14,15). Hepatitis B immunoglobulin (HBIG) has been shown to decrease the rate of recurrence after liver transplantation for hepatitis B (16). Antibodies to the hepatitis B surface antigen (anti-HBs) are collected from individuals who have been hyperimmunized with hepatitis B vaccine. Varicella-zoster immunoglobulin (VZIG) is a prophylactic agent against chickenpox in immunocompromised children and is used in the prevention of postnatal chickenpox after intrauterine exposure and in immunocompromised
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Table 2<br />
Summary of Favorable Functions of Antibodies <strong>for</strong> In Vivo Application<br />
Purpose Favorable functions Preferred type of antibody Favorable expression system<br />
In vivo imaging of tumors <strong>for</strong> Specific recognition and binding, Fab, Fv E. coli, yeast, others<br />
diagnostic purpose rapid serum clearance<br />
Target agent <strong>for</strong> immunotoxins High specificity, rapid serum Bispecific antibodies or fragments, E. coli, chemical modification.<br />
clearance conjugated antibodies<br />
Neutralization of toxins after High affinity Fab, or whole antibody E. coli or others<br />
accident<br />
Prevention of infection Specific recognition of infective IgG, IgA, IgM Mammalian cells as CHO, NSO,<br />
target epitopes; also functional BHK, hybridoma<br />
in mucosa<br />
Treatment of manifest As mentioned be<strong>for</strong>e plus: IgG, IgA, IgM Mammalian cells at high<br />
infections or diseases; long- neutralization such as expression levels and low<br />
term high-dose repeat complement and ADCC, no costs<br />
treatment ADE<br />
Abbreviations: ADCC, antibody-dependent cellular cytotoxicity; ADE, antibody-dependent enhancement.
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