Title:Therapeutic Monoclonal Antibodies and Multiple Sclerosis: The Essentials
Volume: 14
Issue: 2
Author(s): Ioannis Heliopoulos*Athanasia Patousi
Affiliation:
- Department of Neurology, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis,Greece
Keywords:
Alemtuzumab, daclizumab, monoclonal antibodies, natalizumab, ocrelizumab, ofatumumab, phage peptide libraries,
rituximab, transgenic mice.
Abstract: Background: Monoclonal antibodies (mAbs) are now established as targeted therapies for
malignancies, transplant rejection, autoimmune and infectious diseases. Two monoclonal antibodies
are available for treatment and other antibodies are currently being tested in multiple sclerosis (MS)
patients.
Objectives: The purpose of the present review paper is to outline the antibody engineering technologies,
the immunologic and pharmacologic concepts of mbs and the current status of treatment in MS with
emphasis on clinical efficacy and safety.
Method: We conducted a through review of the scientific literature published until 31 December 2014
(print and electronic publications) concerning the production, applications and side effects of the use of
Mabs. Sixty five articles were used in total (both original research and review papers).
Conclusion: With the introduction of mAbs the treatment of MS has entered a new era, both with respect
to efficacy and target specificity. However, administration of mAbs carries the risk of immune
reactions such as acute anaphylaxis, serum sickness, infection and other autoimmune diseases. In addition,
unexpected consequences arise from our incomplete knowledge of the immune system. For example,
natalizumab, a monoclonal antibody targeting α4-integrin on leukocytes increases the risk of
developing progressive multifocal leukoencephalopathy, without causing notable immunosuppression.
Further study on the use of mabs is required, both in vitro and in the clinical field, in order to increase
our knowledge upon these new revolutionary therapeutic agents.
