Monoclonal antibodies: From magic bullet to precision weapon

Abstract

Monoclonal antibodies (mAbs) are used to prevent, detect, and treat a broad spectrum of non-communicable and communicable diseases. Over the past few years, the market for mAbs has grown exponentially with an expected compound annual growth rate (CAGR) of 11.07% from 2024 (237.64 billion USD estimated at the end of 2023) to 2033 (679.03 billion USD expected by the end of 2033). Ever since the advent of hybridoma technology introduced in 1975, antibody-based therapeutics were realized using murine antibodies which further progressed into humanized and fully human antibodies, reducing the risk of immunogenicity. Some benefits of using mAbs over conventional drugs include a drastic reduction in the chances of adverse reactions, interactions between drugs, and targeting specific proteins. While antibodies are very efficient, their higher production costs impede the process of commercialization. However, their cost factor has been improved by developing biosimilar antibodies as affordable versions of therapeutic antibodies. Along with the recent advancements and innovations in antibody engineering have helped and will furtherly help to design bio-better antibodies with improved efficacy than the conventional ones. These novel mAb-based therapeutics are set to revolutionize existing drug therapies targeting a wide spectrum of diseases, thereby meeting several unmet medical needs. This review provides comprehensive insights into the current fundamental landscape of mAbs development and applications and the key factors influencing the future projections, advancement, and incorporation of such promising immunotherapeutic candidates as a confrontation approach against a wide list of diseases, with a rationalistic mentioning of any limitations facing this field.

Keywords: AI-assisted mAbs development; Immunotherapeutic; In vitro display; Magic bullet; Monoclonal antibodies (mAbs); Next-generation mAbs.

Fig. 1

An illustrative diagrammatic presentation of the overall journey and the shiny remarks of the mAbs development technologies, advancement, and the most prominent approved mAbs

Fig. 2

A detailed diagrammatic illustration of the distinctive structural similarities and differences between all known categories and types of antibodies

Fig. 3

Illustrative diagram for the general flow and major steps of the hybridoma technology

Fig. 4

Diagrammatic description of the effect of anacetrapib monoclonal antibody on lipid profile and cardiovascular system

Fig. 5

Diagrammatic illustration of the mechanism of two monoclonal antibodies utilized for treating eosinophilic asthma, mepolizumab and benralizumab. Mepolizumab specifically targets interleukin-5 (IL-5), a cytokine crucial for developing, differentiating, and surviving eosinophils in bone marrow. In comparison, benralizumab attaches to interleukin-5 receptor alpha (IL-5Rα) present on eosinophil surfaces

Fig. 6

Illustrative diagram of the two main approaches of the antibacterial therapeutic antibodies. In the direct approach, three possible modes of action can occur; inactivate pathogens and toxins by neutralization, phagocytosis of the bacteria through opsonization, and lysis of the target bacteria by complement activation. In the indirect approach, antibiotics bind to antibodies by a linker, the antibody attaches specifically to its target receptor on the surface of the bacteria where the antibiotic is released, performing its destructive action on the target bacteria