Antibody therapy: weapon against cancer

Antibodies are important components of the human immune system. In the context of antibody therapy, they are used for therapeutic purposes.

Antibody therapy is used today for example for the treatment of cancer.

Antibodies are special proteins that are naturally part of the human immune system and play an important role in the immune system. They are also called immunoglobulins. Antibodies recognize foreign body or altered body-own structures (so-called antigens) and mark them, so that they are well recognizable and can be eliminated for other components of the immune system, which are responsible for the defense.
The body form a wide variety of antibodies. Their most important natural function is the defense against pathogens .
However, antibodies can also be manufactured artificially and used to treat certain diseases. In this case one speaks of an antibody therapy.

How does the antibody therapy work?
The antibodies that are used therapeutically are directed against very specific structures in the body that play an important role in the onset of disease or in the course of the disease. For example, there are special groups of antibodies that block specific receptors on which the cancer cells dock, thereby reducing cell division and, thus, the growth of a tumor. Other antibodies attach to tumor cells and trigger a defense reaction.
In addition, there are also antibodies that target inflammatory messengers, which play a role in autoimmune diseases such as rheumatism or multiple sclerosis, and can initiate their control by the body's immune system.
An important prerequisite for the development of therapeutic antibodies is the exact investigation of the respective disease processes and relevant endogenous defense mechanisms. Especially in recent years, great progress has been made here. Today, patients with various diseases have therapeutic antibodies available. Many new drugs are currently being studied in studies.

Monoclonal antibodies

For therapeutic purposes, predominantly so-called monoclonal antibodies are used today. These are artificial antibodies produced by genetic engineering in the laboratory, which can be produced specifically for the recognition of specific structures. In contrast to the monoclonal antibodies previously produced from mouse cells, the modern monoclonal antibodies are "humanized", that is, the proportion of animal protein is significantly reduced. This largely prevents the human immune system from classifying these proteins as "foreign" and fighting them as part of a defense reaction. 

When is an antibody therapy paid by the health insurance companies?
Antibody therapies are often part of the standard benefits of the statutory health insurance, if they are prescribed according to the current therapy recommendations. For the most part, they are not the drug of first choice, but are recommended only in certain stages of the disease or in certain disease processes . In the case of cancer, special features of the tumors, which speak in favor of or against the efficacy of antibody therapy, also play a part. Therefore, preliminary studies are preceded by a regulation.

When the antibody therapy is used
Specific monoclonal antibodies are currently being used to treat cancer and autoimmune diseases. The most important indications (indications) for which antibodies have already been approved for treatment include:
  • Use in transplantation medicine to prevent rejection reactions
  • Blood Cancer ( Leukemia ) and Lymphoma ()
  • Other cancers such as breast cancer , colon cancer , squamous cell carcinomaof the head and neck
  • Autoimmune diseases such as, psoriatic arthritis, ankylosing spondylitis
  • Chronic inflammatory bowel disease : Crohn's disease , ulcerative colitis
  • Severe allergic asthma
Therapeutic antibodies are usually used when conventional treatments do not work. In many cases, the course of the disease can be positively influenced. In cancer therapy, it is often used in addition to other treatments such as surgery, radiation, chemotherapy or hormone therapy.
In addition to the already approved therapeutic antibodies for the indicated indications, further antibodies for new indications are currently being tested in studies.

How does the antibody therapy work?
Depending on the preparation, therapeutic antibodies are usually available as infusion therapy or as injection therapy (injections). The dose is given regularly, depending on the type of antibody therapy and the individual requirements of the patient, for example, in one, two or four weeks apart. Often a medical supervision of the patient during the infusion or injection and / or preparatory measures such as the administration of an antiallergic (antihistamine) is necessary.
In the case of injection therapy (administration of the active substance in the form of syringes) it is also possible in some cases for the patient to inject himself after appropriate instruction in the injection technique at home, if the doctor considers it appropriate and if medical follow-up examinations are required ,
Before initiating antibody therapy, various preliminary studies must be performed to rule out health problems and situations that may be against antibody therapy. In addition, the doctor will check in advance whether the conditions for the effectiveness of the intended antibody therapy in the patient are given. Thus, certain antibodies in cancer therapy only in tumors with very specific tumor properties.
As part of the antibody therapy is usually a close monitoring and control of the patient is required because sometimes serious side effects may occur, which sometimes require a discontinuation of therapy.

Antibody therapy: risks
In many cases, antibody therapy is a good way to positively influence the course of the disease. Patients benefit from an improved quality of life . Depending on the area of ​​application, the progression of a disease can in some cases even be delayed in the long term. However, the use of therapeutic antibodies is associated with certain risks and side effects, which may vary depending on the antibody therapy used. Benefits and risks must be weighed before use.

Depending on the antibody used, the risks of antibody therapy include, for example, hypersensitivity reactions such as fever , chills , nausea , skin rash , respiratory distress , itching and swelling. It is also possible immune reactions to healthy tissue (not only cancer cells are detected and rendered harmless) or suppression of the immune system with a significantly increased risk of serious infectionswhen using an antibody therapy, which is directed against structures of the immune system.
Im letzteren Fall sind auch sogenannte opportunistische Infektionen möglich. Davon spricht man, wenn sich Erreger, die im gesunden Organismus in Schach gehalten werden können, eine geschwächte Verfassung des Körpers (vor allem des Immunsystems) zunutze machen, um sich zu vermehren. Entsprechende opportunistische Infektionen, die im Zusammenhang mit bestimmten Antikörpertherapien auftreten können, sind Tuberkulose oder die progressive multifokale Leukenzephalopathie (PML), eine schwere, zum Teil auch tödlich verlaufende Hirnerkrankung, die durch das humane Polyoma-Virus  (JC-Virus) hervorgerufen wird.
In order to recognize appropriate risks and side effects in the course of therapy in good time, it is necessary to closely monitor the patient during the antibody therapy For example, regular blood count checks and further examinations are used.
In addition to those mentioned, additional side effects and risks may be possible in conjunction with the use of individual therapeutic antibodies, which the physician will refer to. 
Generally, there is a risk that the body will recognize the therapeutic antibody itself as a foreign body and form antibodies against it. This has the consequence that the therapy after an initial therapeutic success later shows no effect and must be discontinued or replaced by another.

Antibody therapy: Contraindications
In certain cases, antibody therapy may not be performed. This is the case, for example, depending on the antibody used
  • Hypersensitivity to the active substance or any of the excipients exists
  • There is active tuberculosis or other serious infections
  • The patient is suffering from moderate to severe heart failure (heart failure)
  • When the patient has a weakened immune system, for example due to another existing chronic disease or a necessary medication
Other contraindications that arise depending on the particular antibody therapy will be discussed by the physician and the presence of the patient.

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