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Perspective

Have we overestimated the benefit of human(ized) antibodies?

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Pages 682-694 | Received 27 Sep 2010, Accepted 13 Sep 2010, Published online: 01 Nov 2010

Figures & data

Figure 1 Immunogenicity of monoclonal antibodies. There are numerous mechanisms that may account for the immunogenicity of monoclonal antibodies. Importantly, many of these phenomena act synergistically, potentiating life-threatening immune responses. In the case of anti-CD3 antibodies such as OKT3, the antibody can bind to the CD3 receptor freely, or in the context of antigen-presenting cells (APCs) through Fc receptor binding. This presentation cross-links the CD3 molecule on the T-cell surface, triggering immunoreceptor tyrosine-based activation motif (ITAM)-mediated T-cell activation. In the case of some human antibodies, complementarity-determining regions may also be presented to the T cells in the context of major histocompatibility complex. No matter the form of T-cell presentation, all trigger ITAM-mediated cytokine production. Some cytokines, including interleukin (IL)-2, act in a positive feedback loop on the T cells, causing further T-cell activation, proliferation and cytokine production. Other cytokines, such as tumor necrosis factor (TNF), mediate febrile responses and, in conjunction with interferon (IFN)γ, activate APCs, which may produce their own set of pro-inflammatory cytokines. In addition to APC activation, IFNγ also stimulates affinity maturation in B cells, also known as class switching. Initially, B cells will produce transient low-affinity antibodies, with little to no clinical relevance. However, cytokines such as IFNγ drive B cells to produce antibodies with high affinity. In the context of protein therapeutics, these antibodies are usually IgG antibodies that may exhibit long serum half lives and neutralizing properties.

Figure 1 Immunogenicity of monoclonal antibodies. There are numerous mechanisms that may account for the immunogenicity of monoclonal antibodies. Importantly, many of these phenomena act synergistically, potentiating life-threatening immune responses. In the case of anti-CD3 antibodies such as OKT3, the antibody can bind to the CD3 receptor freely, or in the context of antigen-presenting cells (APCs) through Fc receptor binding. This presentation cross-links the CD3 molecule on the T-cell surface, triggering immunoreceptor tyrosine-based activation motif (ITAM)-mediated T-cell activation. In the case of some human antibodies, complementarity-determining regions may also be presented to the T cells in the context of major histocompatibility complex. No matter the form of T-cell presentation, all trigger ITAM-mediated cytokine production. Some cytokines, including interleukin (IL)-2, act in a positive feedback loop on the T cells, causing further T-cell activation, proliferation and cytokine production. Other cytokines, such as tumor necrosis factor (TNF), mediate febrile responses and, in conjunction with interferon (IFN)γ, activate APCs, which may produce their own set of pro-inflammatory cytokines. In addition to APC activation, IFNγ also stimulates affinity maturation in B cells, also known as class switching. Initially, B cells will produce transient low-affinity antibodies, with little to no clinical relevance. However, cytokines such as IFNγ drive B cells to produce antibodies with high affinity. In the context of protein therapeutics, these antibodies are usually IgG antibodies that may exhibit long serum half lives and neutralizing properties.

Table 1 Human(ized) and rodent derived antibodies that have been tested in humans