The Parish Magazine April 2024

30 The Parish Magazine - April 2024
HEALTH
Dr Simon Ruffle writes . . . Monoclonal Antibodies
Sounds a bit scientific and
impenetrable?
Not really when we understand how
many functions and processes in the
body work.
When I was at medical school this
subject was in its infancy. We were
taught a lock and key principle.
Essentially a protein on the
surface of cells (antigen) would
accept a key (antibody) and this
would unlock the process within the
cell.
The antibody can be specific to
the antigen or there may be some
partial action — this is important
when considering using antibodies
as treatments.
Most of us have heard of
antibodies that ‘attack’ viruses
and bacteria in terms of infection
but they also have a role in cancer,
multiple sclerosis, joint disease,
asthma, migraine and many more
diseases.
CLEVER SCIENTISTS
Monoclonal means a single colony
of antibodies, that is, one type only.
These are man made and are
designed to attach to one antigen
that is specific to the process causing
disease. This should mean that the
treatment is very clean without side
effects.
Unfortunately this is not aways
the case as some antibodies attach to
more than one antigen but also the
antigen and subsequent process may
not just be associated with a disease
but also a normal process.
We, I mean the clever scientists,
can attach drugs to the antibodies
so they are delivered directly to the
cell. One drug for lymphoma sticks a
drug to the B-cells that have become
cancerous, triggering cell death.
Other antibodies have radioactive
particle attached to them.
Some monoclonal antibodies also
attach to proteins that are ‘free’ in
the body and thus preventing them
attaching to the cell where they are
supposed to. Some diseases are a
result of over production of proteins
or over production of ‘locks’ on some
cells.
I remember a very short course
on ‘immunotherapy’ at medical
Cristian Storto, dreamstime.com
school and a very excitable lecturer
claiming that this would be the
future of medicine, much to the
chagrin of the pharmacology team.
Together these scientists are
changing the way we can treat many
diseases including those diseases
that our own bodies create.
These are known as autoimmune
diseases. We produce abnormal
antibodies that attack our own
bodies. Forms of arthritis are the
most common of these diseases.
We use drugs that suppress
the immune system and
therefore decreasing the antibody
level. Unfortunately this is a
sledgehammer to break a nut, but we
have no alternative.
These drugs by their nature are
toxic to other systems in the body.
Often these systems are where cell
turnover is high. Such as bowel, lung
and skin.
Monoclonal antibodies get past
this problem by being quite specific
and their side effects are mostly
predictable.
One antibody therapy binds to
a receptor that is only found in the
bowel and brain. This is used where
other therapies for migraine have
failed. Predictably the side effects
are in the bowel but as the receptor
antigen is not found elsewhere there
are no other side effects.
These treatments are currently
very expensive but as we learn more
the costs will decrease. Currently
most are for use in cancer treatment,
very successfully in breast cancer.
I’m happy to predict that
my immunology lecturer will
continue to be prescient on this
subject and we need to support our
research industry to develop these
treatments.
WIDELY USED
Currently the production of
a year's worth of a drug to treat
multiple sclerosis is $55,000. There
are some rising to $200,000. This
is without the development costs
which often exceed the millions.
Once called the magic bullet
these treatments change lives for the
better and I’m pleased to say I can’t
keep up with the number of these
treatments but as their safety and
efficacy are proved they will become
more widely used and thus cheaper.
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donations for the
Woodley Food Bank
Please inside remember St Andrew's your
Church which is open
10am - 4pm every day
donations for the Woodley Food
Bank and place them in the box
just inside St Andrew's Church.
Thank you!