Antibodies in Medicine

Use of antibodies in disease diagnosis and therapy

Antibodies are used extensively as diagnostic tools in many different formats. The term applied for antibody based diagnostic tests is “immunoassay”. Antibody-based immunoassays are the most commonly used confirmatory diagnostic assays and is the fastest growing technologies for the analysis of biomolecules. 

Monoclonal antibodies

In the past, most immunoassays were based on polyclonal antisera drawn from immunized rabbits, which provided a good immune response despite having limited antigens. This changed with the advent of monoclonal antibodies, as described in 1975 by Köhler and Milstein.

Monoclonal antibodies revolutionized the use of antibodies in therapy called immunotherapeutics. Monoclonal antibodies have become a large part of immunodiagnostics as well.

Recent advances

Trends in antibody based diagnosis show advances in assay specificity, detection technologies and sensitivity. Sensitivity and specificity is ensured depending on whether or not the antigen to be quantified competes with labelled antigen for a limited number of antibody binding sites.

Flow cytometric analysis

Another important new technology with particular importance in diagnostics is flow cytometric analysis. This uses many new monoclonal antibodies against different cell-surface structures and helps flow cytometry in diagnosis if blood cancers. Flow cytometry has also more recently been used 

Rhesus factor, also known as Rhesus D (RhD) antigen, is an antigen found on red blood cells. Presence of the antigen makes a person Rhesus-positive (Rh+) and absence makes a person Rhesus-negative (Rh–). During normal childbirth, delivery trauma or complications during pregnancy, blood from a fetus can enter the mother's system. In the case of an Rh-incompatible mother and child, there may be sensitization of an Rh- mother to the Rh antigen on the blood cells of the Rh+ child. This may put the remainder of the pregnancy, and any subsequent pregnancies at risk of fetal death due to hemolysis.

For treatment Rho antibodies (specific for human Rhesus D (RhD) antigen) are used. Anti-RhD antibodies are administered as part of a prenatal treatment regimen to prevent sensitization that may occur when a Rhesus-negative mother has a Rhesus-positive fetus.

Antibodies in industry

Antibodies are also used in structure prediction. This information is used for protein engineering, modifying the antigen binding affinity, and identifying an epitope, of a given antibody. X-ray crystallography is one commonly used method for determining antibody structures. This, however, is a difficult process. Computational approaches provide a cheaper and faster alternative to crystallography but results are more equivocal.

Antibodies are thus methods that can be used to predict structures of biomolecules. Online web servers such as ''Web Antibody Modeling'' (WAM) and ''Prediction of Immunoglobulin Structure'' (PIGS) enables computational modeling of antibody variable regions. 

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