Antibody Therapy in Infectious Diseases

Monoclonal Antibody Therapy in Infectious Diseases A. Septic Shock 

As with the anti-TNFa mAbs, neither an immunoadhesin containing type 1 TNF receptor sequences (TNF-RI-Fc fusion protein) (79) nor type II receptor sequences (TNF-RII-Fc fusion protein, etanercept) reduced mortality in patients with septic shock (80). Flowever, unlike the case of the mAh therapy, there appeared to be a significant, dose-dependent increase in mortality with the TNF-RII-Fc construct (doses tested were 0.15 mg/kg, 0.45 mg/kg and 1.5 mg/kg as a single infusion). The reasons for this result and the discrepancy with the mAh data are not clear. It may be related to the lymphotoxin-binding capacity of the TNF-R fusion protein, to the capacity of some mAbs to lyse membrane-associated TNFa-expressing monoytes, or to chance observation. 

It should be stated here that other immunotherapeutic strategies for sepsis, such as interleukin-1 receptor antagonist (IL-lra), also did not 

In contrast to antibacterial antibiotic therapy, inhibition of viral replication is usually difficult to achieve. Therefore preventive strategies, such as vaccination, are frequendy more successful and clinically important. However, vaccines are not available for all viruses furthermore, some viruses, such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV), are ubiquitously present and usually not very pathogenic unless in an immunocompromised host. One strategy to combat viral infecdons in the immunocompromised host is the application of neutralizing mAbs. One such mAh is directed to the F protein of the respiratory syncytial virus (RSV), which afflicts premature newborns with often severe pulmonary infections this mAh appears to be useful in such situations (91). Other mAbs to viral antigens are in development. 

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