Immunotherapy strategies and prospects of polyclonal antibodies’ use in clinical practice (review)

UDC 619:615.373.3

Verkhovsky O.A., Aliper T.I., Chernykh O.Yu., Nepoklonov E.A.

Summary. The term ‘immunotherapy' stands for treatment methods that consist in targeted activation or suppression of immune mechanisms, including methods based on immune sera or specific immunoglobulins extracted therefrom. The therapeutic effect in this case is achieved by way of activating the defence mechanisms and interaction between specific antibodies and the pathogen, which results in the elimination of the latter. Prompt administration of pathogen-specific antibodies ensures rapid onset of therapeutic effect in the event of an individual or animal developing symptoms of envenomation or poisoning with toxins of various origins, or displaying clinical signs of infectious diseases in an acute form. Under such circumstances polyclonal antibodies could become the only tool available to save the patient's life. The present review summarizes data from a number of Russian and overseas publications on antibody therapy approaches in clinical practice and assesses the prospects of this set of methods in the future. The issues covered include immune serum and specific immunoglobulin manufacturing technologies, their putative mechanism of action in vivo as well as indications for conducting antibody therapy. Commercial products manufactured in Russia are reviewed, and stages of purification and fractionation of immunoglobulins and fragments thereof are described. The review includes data on the efficiency of currently available products used as antidotes or in the treatment of a number of diseases with a high mortality rate caused by viruses or toxigenic bacterial strains. Safety and efficiency of immunoglobulin-based products of equine origin is demonstrated, as additional purification steps have recently been implemented to dramatically reduce the incidence and severity of side effects. The clinical potential of immune sera and specific immunoglobulins is reviewed on the basis of the specific activity of IgG-antibodies contained in such products in vitro and the protective activity of these products in vivo. The review also focuses on the neutralization test and haemagglutination inhibition test, two most reliable methods of assessing the specific activity of antiviral immunoglobulin-based products, the results of which can be used to estimate the potential therapeutic effect. In conclusion, feedback from Russian and overseas experts is summarised, the predominant forecast being that antibody therapy is a highly promising tool that could be used in the treatment of emerging and poorly studied diseases, which are particularly difficult to control.

Keywords: immune sera, immunoglobulins, antibodies, antibody therapy, immunity, immune response, therapeutic effect, infectious diseases, envenomation, specific activity, virus neutralization test, haemagglutination inhibition test.

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Author affiliation:

Aliper Taras I., D.Sc. in Biology, professor, Head of R&D Narvac; 16, Gamaleiya st., Moscow, 123098; phone 8 (499) 190-30-54; e-mail: aliper@narvac.com.

Chernykh Oleg Yu., D.Sc. in Veterinary Medicine, Director of the Kropotkin regional veterinary laboratory; 303, Krasnoarmayskaya st., Kropotkin, 352380; phone 8 (86138) 6-23-14; e-mail: gukkvl50@kubanvet.ru.

Nepoklonov Yevgeny A., D.Sc. in Biology, professor, Deputy Head of the Federal Service for Veterinary and Phytosanitary Surveillance of the Russian Federation; 1/11, Orlikov per., Moscow, 107139; phone 8 (499) 975-16-29; e-mail: info@svfk.mcx.ru. /

Responsible for correspondence with the editorial board: Verkhovsky Oleg A., D.Sc. in Biology, professor, Head of the Diagnostic and Prevention Research Institute for Human and Animal Diseases; 16, Gamaleya st., Moscow, 123098; phone 8 (499) 190-75-61, e-mail: info@dpri.ru.