Immunoglobulins: structure and function Immunoglobulins Definition: Glycoprotein molecules that are present on B cells (BCR) or produced by plasma cells (antibodies) in response to an immunogen Immunoglobulin Structure • heavy and light chains • disulfide bonds – inter-chain – intra-chain disulfide bond carbohydrate CL VL CH1 VH CH2 hinge region CH3 Immunoglobulin Structure • variable and constant regions • hinge region disulfide bond carbohydrate • domains – VL & CL – VH & CH1 - CH3 (or CH4) • oligosaccharides CL VL CH1 VH CH2 hinge region CH3 Ribbon structure of IgG mIg = BCR Immunoglobulin Fragments: Structure/Function Relationships antigen binding complement binding site binding to Fc receptors placental transfer ANTIGEN BINDING Hypervariable regions Immunoglobulin Fragments Structure/Function Relationships • Fab papain – antigen binding – valence = 1 – specificity determined by VH and VL • Fc Fc – effector functions Fab Immunoglobulin Fragments: Structure/Function Relationships • Fab pepsin – antigen binding • Fc – effector functions • F(ab’)2 - Bivalent! Fc peptides F(ab’)2 BINDING TO Fc RECEPTORS complex antigen antibodies complexed to complex antigen (A) High-affinity FcRs on the surface of the cell bind monomeric Ig before it binds to antigen. (B) Low-affinity FcRs bind multiple Igs that have already bound to a multivalent antigen. Why do antibodies need an Fc region? the (Fab)2 fragment can • detect antigen • precipitate antigen • block the active sites of toxins or pathogen-associated molecules • block interactions between host and pathogen-associated molecules but can not activate (role of Fc region) • inflammatory and effector functions associated with cells • inflammatory and effector functions of complement • the trafficking of antigens into the antigen processing pathways Variability in different regions of the Ig determines Ig classes or specificity isotype allotype idiotype (Classes/subclasses) Sequence variability of H/Lchain constant regions Allelic variants Sequence variability of H and L-chain variable regions (individual, clonespecific) Human Immunoglobulin Classes encoded by different structural gene segments (isotypes) • • • • • IgG - gamma (γ) heavy chains IgM - mu (μ) heavy chains IgA - alpha (α) heavy chains IgD - delta (δ) heavy chains IgE - epsilon (ε) heavy chains light chain types • kappa (κ) • lambda (λ) MAIN CHARACTERISTICS OF ANTIBODY ISOTYPES 1. Ig isotype Serum concentration Characteristics, functions Trace amounts Major isotype of secondary (memory) immune response Complexed with antigen activates effector functions (Fc-receptor binding, complement activation The first isotype in B-lymphocyte membrane Function in serum is not known Trace amounts Major isotype in protection against parasites Mediator of allergic reactions (binds to basophils and mast cells) 3-3,5 mg/ml Major isotype of secretions (saliva, tear, milk) Protection of mucosal surfaces 12-14 mg/ml 1-2 mg/ml Major isotype of primary immune responses Complexed with antigen activates complement Agglutinates microbes The monomeric form is expressed in B-lymphocyte membrane as antigen binding receptor MAIN CHARACTERISTICS OF ANTIBODY ISOTYPES 2. Features of antibody-antigen interaction Valency: numbers of antigens / antibody Affinity: the strength of interaction between a specific antigen and one binding site of the antibody Avidity: sum of affinities of the binding sites of a a given antibody PRODUCTION OF IMMUNOGLOBULINS BEFORE BIRTH AFTER BIRTH breast milk IgA 100% (adult) maternal IgG IgM IgG IgA 0 3 month 6 9 1 2 3 4 5 adult year Secretory IgA and transcytosis S S SS SS SS SS ss ss J J S S S S S S S S S S S S B J ss SS Epithelial cell pIgR and IgA are internalised ss SS S S J S S J SS SS S S ss IgA and pIgR are transported to the apical surface in vesicles SS ‘Stalk’ of the pIgR is degraded to release IgA containing part of the pIgR - the secretory component SS B cells located in the submucosa produce dimeric IgA Polymeric Ig receptors are expressed on the basolateral surface of epithelial cells to capture IgA produced in the mucosa Antibody production during the primary and the secondary immune response Ig. Concentration level of antibodies secondary response against Szekunder antigen A ’lasyecondary respo primary response against antigen A primer response IgG IgA IgE IgM IgM primary response against antigen B 5 „A” antig éAn Antigen 10 15 20 25 „A” és „B” Antigen A and antigén 30 B napok days napok Antibody production during the primary and the secondary immune response EFFECTOR FUNCTION OF ANTIBODIES 1) 2) 3) 4) Neutralization Opsonization followed by Phagocytosis ADCC Activation of complement (discussed later) OPSONIZATION NEUTRALIZATION Antibody Dependent Cellular Cytotoxicity (ADCC) NK CELL DEGRANULATION MAST CELL DEGRANULATION MONOCLONAL ANTIBODIES versus POLYCLONAL ANTIBODIES Polyclonal antibody response Ag Immunserum Polyclonal antibody Set of B-cells Ag Activated B-cells Antibodyproducing plasma-cells Antigen-specific antibodies Monoclonal antibodies - product of one B-lymphocyte clone - homogeneous in antigenspecificity, affinity, and isotype - can be found in pathologic condition in humans (the product of a malignant cell clone) - advantages against polyclonal antibodies: antibodies of a given specificity and isotype can be produced in high quantity and assured quality. -therapeutic usage of monoclonals: anti-TNF-α therapy in rheumatology, tumor therapy Features of polyclonal and monoclonal antibodies Polyclonal antibody Monoclonal antibody Number of recognized antigen determinants several (frequent crossreactions) mostly one Specificity polyspecific monospecific Affinity Varying (diverse antibodies) high Concentration of nonspecific immunoglobulines high low Cost of preparation low high Standardization Impossible (or uneasy) easy Amount limited unlimited Applicability method-dependent excellent Possible use of monoclonal antibodies - Identifying cell types Immunohistochemistry Characterization of lymphomas with CD (cluster of differentiation) markers - Isolation of cells Isolation of CD34+ stem cells for autologous/allogeneic transplantation (from peripheral blood!) - Blood group determination (with anti-A, anti-B, and anti-D monoclonals) - Identification of cell surface and intracellular antigens Cell activation state - Targeted chemotherapy CD20+ anti-B-cell monoclonals in non-Hodgkin lymphoma Prevention of organ rejection after transplantation Monoclonal antibodies as drugs? Mouse monoclonal antibodies may elicit an immune response upon administration in human subjects. (see immunogenicity-determining factors!) How can we solve this problem? Evolution of monoclonal antibodies Mouse Chimeric Human Humanized Humanized antibodies are antibodies from non-human species whose protein sequences have been modified to increase their similarity to antibody variants produced naturally in humans. PASSZÍV IMMUNIZÁLÁS mouse monoclonal antibodies immunization humanized mouse monoclonal antibodies immunization PROTECTED SUBJECT serum antibody ENDANGERED SUBJECT Human immunoglobulin transgenic mouse human monoclonal antibodies This is a case of PASSIVE IMMUNIZATION Immune system is not activated prompt effect temporary protection/effect Immunoglobulin degradation Monoclonals as drugs - Tumor therapy Monoclonals can be used for targeted chemotherapy of tumors. It is cell-type specific, but not specific to malignant cells! - Immunsuppressive monoclonals Cell-type specific immunsuppression Monoclonals in tumor therapy 1. „Naked MAb”, unconjugated antibody Anti-CD20 (rituximab – Mabthera/Rituxan, chimeric): B-cell Non-Hodgkin lymphoma Anti-CD52 (campath – Mabcampath, humanized): chronic lymphoid leukaemia Anti-ErbB2 (trastuzumab – Herceptin, humanized): breast cancer Anti-VEGF (bevacizumab – Avastin, humanized): colorectalis tu. (+ Lucentis!) Anti-EGFR (cetuximab – Erbitux, chimeric): colorectalis tu. (+ Vectibix, rekomb. humán!) 2. Conjugated antibody Anti-CD20 + yttrium-90 isotope (ibritumomab- Zevalin) Anti-CD20 + iodine-131 (tositumomab – Bexxar) Immunsuppressive antibodies 1. 1. Anti-TNF-α antibodies infliximab (Remicade): since 1998, chimeric adalimumab (Humira): since 2002, recombinant human 2. Etanercept (Enbrel) – dimer fusion protein, TNF-α receptor + Ig Fc-part Not a real monoclonal antibody, no Fab end, the specificity is given by TNF-receptor! Indications of anti-TNF-α therapy: • Rheumatoid arthritis • Spondylitis ankylopoetica (SPA - M. Bechterew) • Psoriasis vulgaris, arthritis psoriatica • Crohn-disease, colitis ulcerosa • (usually - still – not in the first line!) Passive immunization Type Application Intramuscular (less effective due to lower dose) HBV-Ig; Varicella-zoster-Ig; Intravenous (IVIG) Bruton-agammaglobulinaemia; variable and mixed immunodeficiencies with hypogammaglobulinaemia; Anti-venom antibody treatment; Case study (Multiple myeloma) • In 1989, a 55-year-old housewife, who had been in good health her entire life, began to experience excessive fatigue. • Her physician did not find abnormalities on physical examination. • The blood sample revealed mild anemia; red blood cell count was 3.5 x 106 / ml white blood cell count was 3600 / ml (normal 4.2-5.0 x 106 / ml), (normal 5000 / ml). • The sedimentation rate of her red blood cells was 32 mm / h (normal <20 mm / h). (Sedimentation is accelerated when fibrinogen or IgG content of the blood plasma is elevated.) • The concentration of IgG was found to be 3790 mg / dl (normal 600 - 1500 mg / dl), that of IgA 14 mg / dl (normal 150 – 250 mg / dl) and that of IgM 53 mg / dl (normal 75 -150 mg / dl). What happens with the B cells in myeloma multiplex? Healthy individual Myeloma multiplex Case study (Multiple myeloma) • Electrophoresis of her serum revealed the presence of a monoclonal protein, which on further analysis was found to be IgG with lambda light chains. normal serum serum from the patient • Radiographs of all of her bones did not show any abnormality. • No treatment was advised. Case study (Multiple myeloma) • In April 1991 her serum IgG was 4520 mg / dl, and in January 1992 it was 5100 mg / dl. By November 1992, her anemia had worsened and her red blood cell count had fallen to 3.0 x 106 / ml. At the same time her white blood count had fallen to 2600 / ml. • In December 1992, she experienced the sudden onset of upper arm pain and headache. • Radiographs of the skull and the left upper arm showed ‘punched out’ lesions in the bones. Case study (Multiple myeloma) • She was treated with melphalan (methylphenylalanine mustard), corticosteroids, and irradiation. Her symptoms improved. • In April 1993, further chemotherapy was given because of the persisting elevation of her serum IgG. The treatment reduced her serum IgG level from 8200 mg / dl to 6000 mg / dl. • In February and in May 1995, she was found to have pneumonia. She was treated successfully with antibiotics. She recovered from this episode in the hospital and remained fully active. She required blood transfusion for her anemia and complained at times of bone pain. Her serum IgG was stable at 6200 mg / dl. Although she was in relative good health as our case history ended, her outlook for survival was very poor. Recently, bone marrow transplants have been used to cure patients with multiple myeloma. /Myeloma proteins have played an important part in the history of immunology. (Bence-Jones protein, subclasses of IgG, amino acid sequence of immunoglobulin molecule)/ Questions She became anemic (low red blood cell count) and neutropenic (low white blood cell count). What was the cause of this? The proliferation of malignant plasma cells in the bone marrow crowded out blood cell precursors. This creates a limitation on space in the bone marrow. As her disease progressed, she became susceptible to pyogenic infection; for example, she had pneumonia twice in a short period. What is the basis of her susceptibility to these infections? Although her serum IgG concentration is quite elevated, almost all the IgG is secreted by the myeloma cells and is monoclonal. In fact, she has very little normal polyclonal IgG and has been effectively rendered agammaglobulinemic by her disease. In addition, her white blood cell count is decreased and she has too few neutrophils (<1000 / ml) to ingest bacteria in the bloodstream and lungs effectively. A monoclonal immunoglobulin in the serum is called an M-component (‘M’ for myeloma). Is the presence of an M-component in serum diagnostic of multiple myeloma? No. M-component appear in the blood as people age. About 10% of healthy individuals in the ninth decade of live have M-component. This is called benign monoclonal gammopathy. Without bone lesions and presence of many malignant cells in the bone marrow, the diagnosis of multiple myeloma cannot be made. Some people have IgM M-components in their blood. This is due to another malignancy of plasma cells called Waldenström’s macroglobulinemia, which differs in many ways from multiple myeloma and is a more benign disease. B cell tumors Supplementary information Monoclonal antibody nomenclature The nomenclature of monoclonal antibodies is a naming scheme for assigning generic, or nonproprietary names to a group of medicines called monoclonal antibodies. This scheme is used for the World Health Organization’s International Nonproprietary Names. Components of nomenclature: Prefix Target Source Suffix -ki(n)- interleukin as target -u-human -ci(r)- cardiovascular -o-mouse variable mab -co(l)- colonic tumor -xi-chimeric -neu(r)- nervous system Etc. -zu-humanized Etc. Example:Abciximabab- + -ci(r)- + -xi- + -mab, it is a chimeric monoclonal antibody used on the cardiovascular system Immunsuppressive antibodies 2. - Muromonab-CD3 (OKT-3) egér IgG2a Against CD3 pan-T-cell antigen, after transplantation; It is rarely (or not) used nowadays (mouse protein!); ongoing trials in diabetes mellitus, with the humanized version - Omalizumab (Xolair): Anti-IgE humanized IgG1k monoclonal Ind.: allergic asthma, Churg-Strauss sy. - Daclizumab (Zenapax): anti-IL-2 receptor humanized antibody Ind.: transplantation - basiliximab (Simulect): as daclizumab, but chimeric! - efalizumab (Raptiva): anti-CD11a, humanized, used in psoriasis Molecular targeted drugs Name Type Target Indications Alemtuzumab Monoclonal Ab, humanized CD52 CLL, CML Monoclonal IgG1, chimeric IL-2 R transplantation Monoclonal IgG1, chimeric IL-2 R transplantation Monoclonal IgG1, chimeric CD20 Lymphoma Monoclonal IgG1, humanized HER2/neu Monoclonal IgG4, humanized CD33 Breast cancer, NSC lung cancer leukemia Monoclonal IgG1, murine CD20 lymphoma Monoclonal IgG2, murine EGFR-TKI KIT-TKI EpCAM EGFR TK TK CRC NSCLC GIST, CML (Mabcampath) Daclizumab (Zenapax) Basiliximab (Simulect) Rituximab (Rituxan/Mabthera) Trastuzumab (Herceptin) Gemtuzumab Calicheamicinnel konjugált Ibritumomab (Y90) Edrecolomab Gefitinib Imatinib Further possibilities with monoclonals Radioimmunotherapy As Zevalin, Bexxar – monoclonal + isotope Antibody-directed enzyme prodrug therapy (ADEPT) An enzyme is linked to the antibody, and the enzyme will make citotoxic drug from the later administered prodrug Immunoliposomes Targeting nucleotides or drugs in liposomes, linked to an antibody Non-immunological targets as abciximab (ReoPro): inhibition of thrombocyte-aggregation