Monoclonal-Antibody Therapy in Systemic Vasculitis

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Abstract
MONOCLONAL antibodies are potentially useful therapeutic agents in a variety of immunologically mediated diseases, offering the theoretical advantage of selective attack on cells implicated in the immunopathogenesis of these disorders. Antibodies to surface markers on lymphocytes, particularly T cells, have already demonstrated efficacy both in animal models and in clinical allograft rejection.1 2 3 For this purpose, monoclonal antibodies can be used either to block vital receptors for antigen, adhesion, or growth factors or to block target cells by harnessing the various natural effector systems (complement and accessory cells) that are activated by the Fc regions of cell-bound antibodies. The optimal use of these natural effector systems depends on the specificity and isotype of the therapeutic antibody.1 Since the administration of xenogeneic antibodies to humans tends to result in the neutralization of the antibodies by an antiglobulin response, long-term or repeated use of such therapeutic antibodies can be possible only if the agents can be rendered poorly immunogenic.