Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Vaccine. 2009 Dec 30;27 Suppl 6:G38-46. doi: 10.1016/j.vaccine.2009.09.105.
The monoclonal antibody (mAb) revolution that currently provides many new options for the treatment of neoplastic and inflammatory diseases has largely bypassed the field of infectious diseases. Only one mAb is licensed for use against an infectious disease, although there are many in various stages of development. This situation is peculiar given that serum therapy was one of the first effective treatments for microbial diseases and that specific antibodies have numerous antimicrobial properties. The underdevelopment and underutilization of mAb therapies for microbial diseases has various complex explanations that include the current availability of antimicrobial drugs, small markets, high costs and microbial antigenic variation. However, there are signs that the climate for mAb therapeutics in infectious diseases is changing given increasing antibiotic drug resistance, the emergence of new pathogenic microbes for which no therapy is available, and development of mAb cocktail formulations. Currently, the major hurdle for the widespread introduction of mAb therapies for microbial diseases is economic, given the high costs of immunoglobulin preparations and relatively small markets. Despite these obstacles there are numerous opportunities for mAb development against microbial diseases and the development of radioimmunotherapy provides new options for enhancing the magic bullet. Hence, there is cautious optimism that the years ahead will see more mAbs in clinical use against microbial diseases.
单克隆抗体（mAb）的革命为治疗肿瘤和炎症性疾病提供了许多新的选择，但在传染病领域却基本没有涉及。尽管有许多 mAb 处于不同的开发阶段，但只有一种获得了用于传染病治疗的许可。鉴于血清疗法是治疗微生物疾病的首批有效疗法之一，并且特定抗体具有许多抗菌特性，这种情况很特殊。造成针对微生物疾病的 mAb 疗法发展和利用不足的原因有很多，包括目前抗菌药物的可用性、市场规模较小、成本高以及微生物抗原变异等。然而，鉴于抗生素药物耐药性不断增加、出现了尚无治疗方法的新致病性微生物，以及 mAb 鸡尾酒制剂的开发，mAb 在传染病治疗方面的应用前景正在发生变化。目前，鉴于免疫球蛋白制剂成本高，市场相对较小，针对微生物疾病广泛引入 mAb 疗法的主要障碍是经济方面的。尽管存在这些障碍，但针对微生物疾病开发 mAb 仍有许多机会，放射性免疫疗法为增强“神奇子弹”提供了新的选择。因此，人们谨慎乐观地认为，未来几年将有更多的 mAb 用于治疗微生物疾病。
