Artículo de revista
Nuevas armas inmunológicas para la medicina del siglo XXI: Terapia biológica basada en el uso de anticuerpos monoclonales de última generación
Fecha
2003Registro en:
Rev Méd Chile 2003; 131: 1445-1453
0034-9887
Autor
Aguillón Gutiérrez, Juan Carlos
Contreras L., Juan
Dotte G., Andrés
Cruzat C., Andrea
Catalán Martina, Diego
Salazar A., Lorena
Molina S., María Carmen
Guerrero P., Julia
López Nitsche, Mercedes
Soto Sáez, Lilian
Salazar Onfray, Flavio
Cuchacovich Turteltaub, Miguel
Institución
Resumen
The fusion of a murine B cell and a myeloma cell generates a hybridoma that
produces monoclonal antibody (mAb). These murine mAb induce the HAMA (human anti-mouse
antibodies) response. Murine mAb have been modified by genetic engineering, producing molecules
with a higher proportion of human protein. At present, chimeric, humanized and fully human mAb
are available. mAb block interactions between target molecules and their ligands or trigger the lyses
of mAb-coated tumor cells. Numerous mAb have been developed using the recombinant DNA technology
and several are available in the market. Trastuzumab, against HER2/neu, is useful in breast
cancer; rituximab, against CD20 in B lymphocytes is useful in lymphoma; alemtuzumab, against
CD52 is used in lymphoma and leukemia; daclizumab and basiliximab block the IL-2 receptor interaction
and reduce acute rejection in kidney transplantion; abciximab, an antagonist of GPIIb/
IIIa platelet receptor, is used in patients undergoing acute coronary syndromes. In autoimmunity
diseases, blocking tumor necrosis factor by infliximab and adalimumab has demonstrated excellent
results. Thus, infliximab is useful in the treatment of rheumatoid arthritis (RA), Crohn’s disease and
ulcerative colitis while adalimumab is the first fully human mAb available for RA. Infliximab and
adalimumab reduce signs and symptoms in RA and they also interfere with progression of joint
damage. Finally, the direct benefits of antagonist treatment can occur at the expense of a major
adverse effect in some other biological function