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单克隆抗体:综述

Monoclonal Antibodies: A Review.

作者信息

Singh Surjit, Kumar Nitish K, Dwiwedi Pradeep, Charan Jaykaran, Kaur Rimplejeet, Sidhu Preeti, Chugh Vinay K

机构信息

Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.

Department of Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.

出版信息

Curr Clin Pharmacol. 2018;13(2):85-99. doi: 10.2174/1574884712666170809124728.

Abstract

BACKGROUND

Over the last three decades, monoclonal antibodies (MAbs) have made a striking transformation from scientific tools to powerful human therapeutics. Muromonab CD3 a murine MAb was the first FDA approved therapeutic MAb for the prevention of kidney transplant rejection. Since its approval in 1986, there has been a decline in further application and approvals until the late 1990s when the first chimeric Mab, Rituximab was approved for the treatment of lowgrade B cell lymphoma in 1997. With the approval by licensing authorities of chimeric, followed by humanized and then fully human monoclonal antibodies, the rate of approval and monoclonal antibodies available in the market for the treatment of various diseases has increased dramatically. As of March 2017, FDA has approved approximately 60 therapeutic MAbs which are currently under evaluation in various phases of clinical trials.

OBJECTIVE

MAbs are approved for the treatment of diseases belonging to various systems like cardiovascular, respiratory, hematology, kidney, immunology and oncology. MAbs are approved for the treatment of orphan diseases or indications such as paroxysmal nocturnal hemoglobinuria as well as cancers and multiple sclerosis where hundreds of patients are treated and even diseases such as breast cancer, asthma and rheumatoid arthritis where millions are being treated. This review focuses briefly on types, molecular targets, mechanism of actions and therapeutic indications of FDA approved MAb products that are currently available in the market.

CONCLUSION

With the advent of fully human MAbs, the efficacy and safety have improved in the treatment of various cardiovascular, cancer, respiratory, hematology, autoimmune diseases and infections. The introduction of biosimilars will increase the affordability and utilization of MAbs in the treatment of various diseases.

摘要

背景

在过去三十年中,单克隆抗体(MAb)已从科学工具显著转变为强大的人类治疗药物。鼠源单克隆抗体莫罗单抗-CD3是首个获美国食品药品监督管理局(FDA)批准用于预防肾移植排斥反应的治疗性单克隆抗体。自1986年获批以来,其进一步应用和获批数量有所下降,直到20世纪90年代末,首个嵌合单克隆抗体利妥昔单抗于1997年获批用于治疗低度B细胞淋巴瘤。随着嵌合单克隆抗体、随后的人源化单克隆抗体以及全人源单克隆抗体相继获得监管机构批准,市场上用于治疗各种疾病的单克隆抗体的获批率和可用数量大幅增加。截至2017年3月,FDA已批准约60种治疗性单克隆抗体,目前这些抗体正处于临床试验的各个阶段。

目的

单克隆抗体被批准用于治疗属于心血管、呼吸、血液、肾脏、免疫和肿瘤等各个系统的疾病。单克隆抗体被批准用于治疗罕见病或适应症,如阵发性夜间血红蛋白尿以及癌症和多发性硬化症(数百名患者接受治疗),甚至用于治疗乳腺癌、哮喘和类风湿关节炎等疾病(数百万患者接受治疗)。本综述简要聚焦于目前市场上可获得的FDA批准的单克隆抗体制品的类型、分子靶点、作用机制和治疗适应症。

结论

随着全人源单克隆抗体的出现,在治疗各种心血管、癌症、呼吸、血液、自身免疫性疾病和感染方面,疗效和安全性均有所提高。生物类似药的推出将提高单克隆抗体在治疗各种疾病中的可及性和利用率。

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