Anti-immunoglobulin

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Anti-immunoglobulin antibodies are defined as a protein that detects other antibodies from an organism. Specifically, anti-immunoglobulin antibodies are created by B-cells as antibodies to bind to other immunoglobulins. Immunoglobulins have two regions: the constant region and the variable region. The constant region is involved in effector function, while the variable region is involved in recognizing and binding to antigens. Anti-immunoglobulin antibodies may bind to either the variable or constant region of the immunoglobulin. [1] Anti-immunoglobulin antibodies are a type of secondary antibody. They are able to detect primary antibodies through multiple methods such as a Western blot, immunohistochemistry, immunofluorescence staining, flow cytometry, and ELISA. [2]

Contents

Creation of Anti-immunoglobulin Antibodies

The anti-immunoglobulin antibodies are created through recombinant DNA technology. Production via recombinant DNA technology allows the highest level of batch-to-batch reproducibility. This method of antibody engineering can expand the antibody compatibility to multiple assay components. [3] All anti-immunoglobulin antibodies are laboratory-made, so they are a type of clonal antibody. Clonal antibodies are engineered in a laboratory to mimic the effects of primary antibodies. Clonal antibodies can either be monoclonal or polyclonal. Monoclonal antibodies are clones of one antibody; therefore, monoclonal antibodies can only bind to one target. Polyclonal antibodies are clones of multiple antibodies and immune cells, so they can bind to various targets. [4] Recombinant clonal antibodies are produced through in-vitro cloning. The in-vitro cloning process occurs through inserting genes for an antibody's light and heavy region into an expression vector. The vector is then introduced into host cells for expression. [5] Hosts can range from rabbits to mice to goats. Anti-immunoglobulin antibodies are recognizable by their clone name. The clone name is commonly placed in brackets after the written name.[ citation needed ]

Anti-Human Immunoglobulin Antibodies

These are the six different human immunoglobulin antibodies that anti-human immunoglobulin antibodies can recognize via laboratory testing. Antibody Isotypes.png
These are the six different human immunoglobulin antibodies that anti-human immunoglobulin antibodies can recognize via laboratory testing.

Anti-antibodies for human purposes are able to recognize IgM, IgA, IgE, IgD, and IgG. To detect all isotypes of human antibodies, anti-human kappa and lambda light chain antibodies are available. [2] Anti-human immunoglobulin antibodies are available for purchase on a commercial laboratory scale.

Anti-IgG

There are anti-IgG antibodies that are heavy-and-light chain specific, Fc-part specific, and hinge-part specific. [6]

Ant-IgG TypeDescription
Anti-human IgG [17F12] This is a recombinant monoclonal antibody to human IgG. It has the ability to bind to all 4 human IgG subtypes: IgG1, IgG2, IgG3, and IgG4. [7]
Anti-Human IgG [8E11] This is a recombinant monoclonal antibody to human IgG. However, it can screen for IgG in nonhuman primates including vervets, chimpanzees, and mangabeys. The anti-antibody can distinguish between human and nonhuman IgG. [8]
Anti-Pan-Primate IgG [8F1] This is a recombinant monoclonal antibody to Pan-primate IgG. The antibody reacts to most primate IgG, including human IgG. The most important use of anti-Pan-primate is to quantify IgG in homogenates from macaque lungs and lymph nodes. [9]
Anti-IgG [NH3/130.5.2] This is a recombinant monoclonal antibody to IgG. When using ELISA, the anti-antibody also recognizes rhesus macaque IgG1, cynomolgus monkey IgG1, and cynomolgus monkey IgG4. [10]
Anti-IgG3 [NH3/15.8] This is a recombinant monoclonal antibody to IgG3. Anti-IgG3 [NH3/15.8] is most commonly used in human IgG blood transfusion serology testing. [11]

Anti-IgM

IgM antibodies are the largest antibodies and are the first to respond in an immune response. Anti-IgM antibodies are used to detect the presence of IgM antibodies in human serums. IgM antibodies are responsible for blood clotting during incorrect donor blood transfusions. [12]

Anti-IgM TypeDescription
Anti-IgM [M15/8] This is a recombinant monoclonal antibody to IgM. The anti-antibody functions in early detection of antigens in serum rather than interstitial fluids. [13]
Anti-IgM [B481] This is a recombinant monoclonal antibody to IgM. It is recommended to use anti-IgM [B481] as a secondary antibody against IgM primary antibodies. [14]

Anti-IgE

IgE antibodies are the least abundant immunoglobulins in the immune response. They are commonly found in response to allergic reactions. Using anti-antibodies for IgE can help prevent histamine responses. [15]

Anti-IgE TypeDescription
Anti-IgE [huMaE11 (Omalizumab)] This is a recombinant monoclonal antibody to IgE. The antibody binds to IgE circulating in the blood. Therefore, IgE cannot bind to mast cells to trigger a histamine response. Anti-IgE [huMaE11 (Omalizumab)] is used in drugs that treat allergies and asthma. [16]
Anti-IgE [TES-C21] This is a recombinant monoclonal antibody to IgE. The anti-IgE antibody binds specifically to IgE antibodies by B cells (interleukins Il-4 and IL-13). Anti-IgE can be conjugated to cytotoxic drugs in order to deliver them to IgE-producing B cells. [17]

Anti-IgA

The antibody IgA is most commonly found in mucosal secretions such as tears and saliva, but it is rarely found circulating in the bloodstream. Around 15% of antibodies produced each day are the IgA isotype. [18]

Anti-IgA TypeDescription
Anti-IgA [H15A43] This is a recombinant monoclonal antibody to IgA. It specifically binds to the heavy chain of human IgA. Its most relevant application is the purification of IgA from serum. [19]

Anti-IgD

Immature B-lymphocytes most commonly express the IgD isotype. IgD can also be found circulating in blood serum. IgD signals B cells to activate the immune response. This role is also shared by IgM. IgD is functional in the respiratory immune defense system since they activate basophils and mast cells that secrete antimicrobial factors. [20]

Anti-IgD TypeDescription
Anti-IgD [IgD26] This is a recombinant monoclonal antibody. IgD26 can be used as either a primary or secondary antibody. Anti-IgD recognizes the IgD isotype present on immature B cells. [21]

Anti-Lambda Light Chain

Lambda light chains are one of the two classes of light chains present on mammalian immunoglobulins. They are found in combination with kappa light chains. These chains are usually present in a 70:30 ratio of kappa to lambda. Anti-lambda light chain antibodies can nonspecifically bind to multiple isotypes of immunoglobulins. [22]

Immunoglobulins will either express Kappa or Lambda light chains. This is a depiction of an immunoglobulin that expresses Lambda light chains. The anti-lambda light chain immunoglobulins will be able to recognize the Lambda light chains on specific immunoglobulin isotypes. Immunoglobulin G4-lambda, anti-CD3E + anti-TNFRSF17 bispecific.svg
Immunoglobulins will either express Kappa or Lambda light chains. This is a depiction of an immunoglobulin that expresses Lambda light chains. The anti-lambda light chain immunoglobulins will be able to recognize the Lambda light chains on specific immunoglobulin isotypes.
Anti-Lambda Light Chain TypeDescription
Anti-Lambda Light Chain [N10/2] This is a recombinant monoclonal antibody to the Lambda light chain. It does not cross react with Kappa light chains. N10/2 most importantly recognizes pathologies such as leukemias, plasmacytomas, and non-Hodgkin's lymphomas. [22]

Anti-Kappa Light Chain

Kappa light chains are the second of the two classes of light chains present on mammalian immunoglobulins. One immunoglobulin only has one type of light chain. Each light chain has both a constant and a variable region. [23]

Anti-Kappa Light Chain TypeDescription
Anti-Kappa Light Chain [NH3/41.34] This is a recombinant monoclonal antibody to the kappa light chain. Specifically, [NH3/41.34] binds to IgG antibodies via Western blot. There is no cross reactivity with cynomolgus monkey IgG1 and cynomolgus monkey IgG4, which are recognized by Anti-IgG [NH3/130.5.2]. [23]

It is critical to note that these are not the only anti-human immunoglobulin antibodies. These are examples of the most common anti-immunoglobulin antibodies used in current human research. These antibodies can be purchased on a commercial scale.

Anti-Non-Human Immunoglobulin Antibodies

A majority of non-human immunoglobulin antibodies are detected in non-human primate (NHP) models. The NHP models serve as proxies for humans during preclinical studies. The most common NHP models for important antibody isotypes and subtypes include rhesus macaques, cynomolgus monkeys, and baboons. Therefore, certain antibodies will only react with certain NHP species. The most common antibody isotypes are rhesus monkey macaque and cynomolgus monkey IgG1 and IgG4. [3]

Anti-Macaque

Anti-Macaque Antibody TypeDescription
Anti-Macaque pan-species IgG [1B3] This is a recombinant monoclonal antibody to Macaque pan-species IgG. This is used in ELISA to detect anti-rhesus mouse antibodies in serum. The antibody is able to distinguish between human and macaque IgG antibodies. In HIV research it has been used to detect macaque antibodies while against IV-administered HIV broadly neutralizing antibodies. [24]

Anti-Baboon

While the methods used in Anti-baboon antibody creation and detection are very similar, each anti-antibody is responsible for identifying a different isotype of IgG. The isotypes include IgG1, IgG2, IgG3, and IgG4.

Anti-Rhesus Antibody TypeDescription
Anti-Baboon IgG1 [7H4.G8.G10] This is a recombinant monoclonal antibody to baboon IgG1. It specifically reacts with baboon IgG1 via ELISA. There is no cross reactivity with other primate IgG1 subtypes. Immunizing mice against a baboon immunoglobulin gives rise to anti-baboon IgG1. [25]
Anti-Baboon IgG2 [1E11.1] This is a recombinant monoclonal antibody to baboon IgG2. It specifically reacts with baboon IgG2 via ELISA. There is no cross reactivity with other primate IgG2 subtypes. Immunizing mice against a baboon immunoglobulin gives rise to anti-baboon IgG2. [26]
Anti-Baboon IgG3 [4A6.1] This is a recombinant monoclonal antibody to baboon IgG3. It specifically reacts with baboon IgG3 via ELISA. There is no cross reactivity with other primate IgG3 subtypes. Immunizing mice against a baboon immunoglobulin gives rise to anti-baboon IgG3. [27]
Anti-Baboon IgG4 [5F3.E11.G4] This is a recombinant monoclonal antibody to baboon IgG4. It specifically reacts with baboon IgG4 via ELISA. There is no cross reactivity with other primate IgG4 subtypes. Immunizing mice against a baboon immunoglobulin gives rise to anti-baboon IgG4. [28]

Anti-Rhesus

The following anti-rhesus antibodies are isotypes of anti-IgG. The isotypes include IgG1 and IgG4. Both [2C6] and [7A8] are subtypes of anti-IgG4.

Anti-Rhesus Antibody TypeDescription
Anti-Rhesus IgG1 [3C10.3] This is a recombinant monoclonal antibody to rhesus IgG1. It specifically reacts with rhesus IgG1 via ELISA. Specificity of anti-rhesus IgG1 to rhesus IgG1 was confirmed through antibody responses to HIV-1 vaccine in rhesus macaques. [29]
Anti-Rhesus IgG4 [2C6] This is a recombinant monoclonal antibody to rhesus IgG4. It specifically reacts with rhesus IgG4 via ELISA. There is no cross reactivity with other primate IgG4 subtypes. Immunizing mice against a rhesus immunoglobulin gives rise to anti-rhesus IgG4. [30]
Anti-Rhesus IgG4 [7A8] This is a recombinant monoclonal antibody to rhesus IgG4. It specifically reacts with rhesus IgG4 via ELISA. Specificity of anti-rhesus IgG4 to rhesus IgG1 was confirmed through antibody responses to HIV-1 vaccine in rhesus macaques. [31]

Anti-Pan-Primate

Anti-Pan-Primate Antibody TypeDescription
Anti-Pan-Primate IgG [8F1] This is a recombinant monoclonal antibody to pan-primate IgG. This antibody reacts with most primate IgG antibodies, including human IgG. In a research setting the antibody has been used via ELISA to count IgG in supernatants from lung and lymph node tissues from cynomolgus macaques. [32]

Anti-Marmoset

Anti-Marmoset Antibody TypeDescription
Anti-Marmoset IgG [4H12] This is a recombinant monoclonal antibody to marmoset-IgG. The antibody minimally reacts with IgG antibodies from other primate species. The specificity of the antibody was confirmed via ELISA. [33]

It is critical to note that these are not the only anti-non-human immunoglobulin antibodies. These are examples of the most common anti-immunoglobulin antibodies used in current NHP research.

Clinical Applications

Recombinant monoclonal anti-immunoglobulin antibodies have various clinical applications that include diagnosis, disease treatment, and research. The most practical use for anti-immunoglobulin antibodies is in diagnostic tests. Assays use anti-immunoglobulin antibodies to detect immune responses in cancer patients, autoimmune therapy drug developments, infectious disease studies, and vaccine trials. [3] The most current application of anti-immunoglobulin antibodies is in the development of asthma treatments and COVID-19 detection.

Anti-immunoglobulin IgE antibodies are currently being used in asthma treatment medications for severe cases. The treatment focuses on bronchial asthma which is defined as the chronic inflammation of airways. Symptoms include wheezing, dyspnea, and cough. The use of anti-immunoglobulin E antibodies is reserved for severe cases of asthma that are related to allergic reactions. Long term treatment plans for severe asthma come in four steps, with use of an anti-IgE antibody being used in the fourth step in conjunction with an inhaled corticosteroid. The use of anti-IgE antibodies in treatment is only effective in patients with a serum total IgE value within 30-1500 IU/mL. Omalizumab is the drug therapy used to deliver the anti-immunoglobulin E antibodies. Omalizumab is a human anti-IgE monoclonal antibody. It blocks IgE-mediated reactions and reduces asthma symptoms by binding to free IgE antibodies in serum. The drug is delivered every 2-4 weeks depending on severity of the patient. Effectiveness of the drug is predictive of higher eosinophil counts, higher serum periostin counts, and higher fractional exhaled nitric oxide levels. The treatment is effective in about 60% of patients. [34]

With the spread of COVID-19 worldwide, it became vital for researchers to develop an efficient method to detect COVID-19 in PCR tests. In 2021 researchers developed an assay to detect both viral RNA and human antibodies from one clinical sample. The assay is known as OPIPE, a one-pot pre-coated interface proximity extension assay. The assay recognizes antibodies by using a pre-coated antigen interface and a pair of anti-antibodies labeled with oligosaccharides. The recognized antibodies extend to double stranded DNA templates to initiate the final steps of the PCR. The serum detection level is 100 fg/mL for the anti-SARS-CoV-2 antibody and 10 copies/μL for viral DNA. [35] The success of the method to co-detect viral RNA and human antibodies is imperative in finding cheaper alternatives for COVID-19 infection identifications.

Related Research Articles

<span class="mw-page-title-main">Antibody</span> Protein(s) forming a major part of an organisms immune system

An antibody (Ab) is the secreted form of a B cell receptor; the term immunoglobulin (Ig) can refer to either the membrane-bound form or the secreted form of the B cell receptor, but they are, broadly speaking, the same protein, and so the terms are often treated as synonymous. Antibodies are large, Y-shaped proteins belonging to the immunoglobulin superfamily which are used by the immune system to identify and neutralize foreign objects such as bacteria and viruses, including those that cause disease. Antibodies can recognize virtually any size antigen with diverse chemical compositions from molecules. Each antibody recognizes one or more specific antigens. This term literally means "antibody generator", as it is the presence of an antigen that drives the formation of an antigen-specific antibody. Each tip of the "Y" of an antibody contains a paratope that specifically binds to one particular epitope on an antigen, allowing the two molecules to bind together with precision. Using this mechanism, antibodies can effectively "tag" a microbe or an infected cell for attack by other parts of the immune system, or can neutralize it directly.

<span class="mw-page-title-main">Immunoglobulin G</span> Antibody isotype

Immunoglobulin G (IgG) is a type of antibody. Representing approximately 75% of serum antibodies in humans, IgG is the most common type of antibody found in blood circulation. IgG molecules are created and released by plasma B cells. Each IgG antibody has two paratopes.

<span class="mw-page-title-main">Immunoglobulin E</span> Immunoglobulin E (IgE) Antibody

Immunoglobulin E (IgE) is a type of antibody that has been found only in mammals. IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains and two light chains, with the ε chain containing four Ig-like constant domains (Cε1–Cε4). IgE is thought to be an important part of the immune response against infection by certain parasitic worms, including Schistosoma mansoni, Trichinella spiralis, and Fasciola hepatica. IgE is also utilized during immune defense against certain protozoan parasites such as Plasmodium falciparum. IgE may have evolved as a defense to protect against venoms.

<span class="mw-page-title-main">Immunoglobulin M</span> One of several isotypes of antibody

Immunoglobulin M (IgM) is the largest of several isotypes of antibodies that are produced by vertebrates. IgM is the first antibody to appear in the response to initial exposure to an antigen; causing it to also be called an acute phase antibody. In humans and other mammals that have been studied, plasmablasts in the spleen are the main source of specific IgM production.

<span class="mw-page-title-main">Cryoglobulinemia</span> Medical condition

Cryoglobulinemia is a medical condition in which the blood contains large amounts of pathological cold sensitive antibodies called cryoglobulins – proteins that become insoluble at reduced temperatures. This should be contrasted with cold agglutinins, which cause agglutination of red blood cells.

<span class="mw-page-title-main">Immunoglobulin heavy chain</span> Large polypeptide subunit of an antibody

The immunoglobulin heavy chain (IgH) is the large polypeptide subunit of an antibody (immunoglobulin). In human genome, the IgH gene loci are on chromosome 14.

Theralizumab is an immunomodulatory drug developed by Thomas Hünig of the University of Würzburg. It was withdrawn from development after inducing severe inflammatory reactions as well as chronic organ failure in the first-in-human study by Parexel in London in March 2006. The developing company, TeGenero Immuno Therapeutics, went bankrupt later that year. The commercial rights were then acquired by a Russian startup, TheraMAB. The drug was renamed TAB08. Phase I and II clinical trials have been completed for arthritis and clinical trials have been initiated for cancer.

<span class="mw-page-title-main">Complement component 1q</span> Protein complex

The complement component 1q is a protein complex involved in the complement system, which is part of the innate immune system. C1q together with C1r and C1s form the C1 complex.

<span class="mw-page-title-main">Immunoglobulin light chain</span> Small antibody polypeptide subunit (immunoglobin)

The immunoglobulin light chain is the small polypeptide subunit of an antibody (immunoglobulin).

<span class="mw-page-title-main">Allotype (immunology)</span>

The word allotype comes from two Greek roots, allo meaning 'other or differing from the norm' and typos meaning 'mark'. In immunology, allotype is an immunoglobulin variation that can be found among antibody classes and is manifested by heterogeneity of immunoglobulins present in a single vertebrate species. The structure of immunoglobulin polypeptide chain is dictated and controlled by number of genes encoded in the germ line. However, these genes, as it was discovered by serologic and chemical methods, could be highly polymorphic. This polymorphism is subsequently projected to the overall amino acid structure of antibody chains. Polymorphic epitopes can be present on immunoglobulin constant regions on both heavy and light chains, differing between individuals or ethnic groups and in some cases may pose as immunogenic determinants. Exposure of individuals to a non-self allotype might elicit an anti- allotype response and became cause of problems for example in a patient after transfusion of blood or in a pregnant woman. However, it is important to mention that not all variations in immunoglobulin amino acid sequence pose as a determinant responsible for immune response. Some of these allotypic determinants may be present at places that are not well exposed and therefore can be hardly serologically discriminated. In other cases, variation in one isotype can be compensated by the presence of this determinant on another antibody isotype in one individual. This means that divergent allotype of heavy chain of IgG antibody may be balanced by presence of this allotype on heavy chain of for example IgA antibody and therefore is called isoallotypic variant. Especially large number of polymorphisms were discovered in IgG antibody subclasses. Which were practically used in forensic medicine and in paternity testing, before replaced by modern day DNA fingerprinting.

<span class="mw-page-title-main">Isotype (immunology)</span>

In immunology, antibodies are classified into several types called isotypes or classes. The variable (V) regions near the tip of the antibody can differ from molecule to molecule in countless ways, allowing it to specifically target an antigen . In contrast, the constant (C) regions only occur in a few variants, which define the antibody's class. Antibodies of different classes activate distinct effector mechanisms in response to an antigen . They appear at different stages of an immune response, differ in structural features, and in their location around the body.

<span class="mw-page-title-main">Protein L</span>

Protein L was first isolated from the surface of bacterial species Peptostreptococcus magnus and was found to bind immunoglobulins through L chain interaction, from which the name was suggested. It consists of 719 amino acid residues. The molecular weight of protein L purified from the cell walls of Peptostreptoccus magnus was first estimated as 95kD by SDS-PAGE in the presence of reducing agent 2-mercaptoethanol, while the molecular weight was determined to 76kD by gel chromatography in the presence of 6 M guanidine HCl. Protein L does not contain any interchain disulfide loops, nor does it consist of disulfide-linked subunits. It is an acidic molecule with a pI of 4.0. Unlike protein A and protein G, which bind to the Fc region of immunoglobulins (antibodies), protein L binds antibodies through light chain interactions. Since no part of the heavy chain is involved in the binding interaction, Protein L binds a wider range of antibody classes than protein A or G. Protein L binds to representatives of all antibody classes, including IgG, IgM, IgA, IgE and IgD. Single chain variable fragments (scFv) and Fab fragments also bind to protein L.

Tanox was a biopharmaceutical company based in Houston, Texas. The company was founded by two biomedical research scientists, Nancy T. Chang and Tse Wen Chang in March 1986 with $250,000, which was a large part of their family savings at that time. Both Changs grew up and received college education in chemistry in National Tsing Hua University in Taiwan and obtained Ph.D. degrees from Harvard University. For postdoctoral training, Tse Wen shifted to immunology and did research with Herman N. Eisen at the Center for Cancer Research, M.I.T. The two Changs successively became research managers and worked with a range of monoclonal antibody projects in Centocor, Inc. based in Malvern, Pennsylvania, from 1981 to 1985. The Changs were recruited by Baylor College of Medicine toward the end of 1985 and offered faculty positions in the Division of Molecular Virology. Soon after their arrival, they were encouraged by a high-ranking Baylor official and local business leaders to start a biotech venture in Houston. This was in a period of time when the economy of Houston was in slump as the result of the collapse of the oil industry.

<span class="mw-page-title-main">Myeloma protein</span> Abnormal immunoglobulin fragment

A myeloma protein is an abnormal antibody (immunoglobulin) or a fragment thereof, such as an immunoglobulin light chain, that is produced in excess by an abnormal monoclonal proliferation of plasma cells, typically in multiple myeloma or Monoclonal gammopathy of undetermined significance. Other terms for such a protein are monoclonal protein, M protein, M component, M spike, spike protein, or paraprotein. This proliferation of the myeloma protein has several deleterious effects on the body, including impaired immune function, abnormally high blood viscosity, and kidney damage.

<span class="mw-page-title-main">IGHM</span> Gene in the species Homo sapiens

Ig mu chain C region is a protein that in humans is encoded by the IGHM gene.

<span class="mw-page-title-main">IgG deficiency</span> Form of immune disorder

IgG deficiency is a form of dysgammaglobulinemia where the proportional levels of the IgG isotype are reduced relative to other immunoglobulin isotypes.

In hematology, plasma cell dyscrasias are a spectrum of progressively more severe monoclonal gammopathies in which a clone or multiple clones of pre-malignant or malignant plasma cells over-produce and secrete into the blood stream a myeloma protein, i.e. an abnormal monoclonal antibody or portion thereof. The exception to this rule is the disorder termed non-secretory multiple myeloma; this disorder is a form of plasma cell dyscrasia in which no myeloma protein is detected in serum or urine of individuals who have clear evidence of an increase in clonal bone marrow plasma cells and/or evidence of clonal plasma cell-mediated tissue injury. Here, a clone of plasma cells refers to group of plasma cells that are abnormal in that they have an identical genetic identity and therefore are descendants of a single genetically distinct ancestor cell.

Complement-dependent cytotoxicity (CDC) is an effector function of IgG and IgM antibodies. When they are bound to surface antigen on target cell, the classical complement pathway is triggered by bonding protein C1q to these antibodies, resulting in formation of a membrane attack complex (MAC) and target cell lysis.

Recombinant antibodies are antibody fragments produced by using recombinant antibody coding genes. They mostly consist of a heavy and light chain of the variable region of immunoglobulin. Recombinant antibodies have many advantages in both medical and research applications, which make them a popular subject of exploration and new production against specific targets. The most commonly used form is the single chain variable fragment (scFv), which has shown the most promising traits exploitable in human medicine and research. In contrast to monoclonal antibodies produced by hybridoma technology, which may lose the capacity to produce the desired antibody over time or the antibody may undergo unwanted changes, which affect its functionality, recombinant antibodies produced in phage display maintain high standard of specificity and low immunogenicity.

Monoclonal gammopathy of renal significance (MGRS) are a group of kidney disorders that present with kidney damage due to nephrotoxic monoclonal immunoglobulins secreted by clonal plasma cells or B cells. By definition, people with MGRS do not meet criteria for multiple myeloma or other hematologic malignancies. The term MGRS was introduced in 2012 by the International Kidney and Monoclonal Gammopathy Research Group (IKMG). MGRS is associated with monoclonal gammopathy of undetermined significance (MGUS). People with MGUS have a monoclonal gammopathy but does not meet the criteria for the clonal burden nor the presence of end organ damage seen in hematologic malignancies. In a population based study based on the NHANES III health survey; 6% of patients with MGUS were subsequently classified as having MGRS. The prevalence and incidence of MGRS in the general population or in specific populations is not known but it is more prevalent in those over the age of 50 as there is a monoclonal protein (M-protein) present in 3% of those 50 and years older and 5% of those 70 years and older, placing those 50 and older at increased risk of MGRS.

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