RETURN TO THE PAST - THE CASE FOR ANTIBODY-BASED THERAPIES IN INFECTIOUS-DISEASES

In the preantibiotic era, passive antibody administration (serum thera py) aas useful for the treatment of many infectious diseases. The intr oduction of antimicrobial chemotherapy in the 1940s led to the rapid a bandonment of many forms of passive antibody therapy. Chemotherapy was more effective and less toxic than antibody therapy. In this last dec ade of the 20th century the efficacy of antimicrobial chemotherapy is diminishing because of the rapidly escalating number of immunocompromi sed individuals, the emergence of new pathogens, the reemergence of ol d pathogens, and widespread development of resistance to antimicrobial drugs. This diminishment in the effectiveness of chemotherapy has bee n paralleled by advances in monoclonal antibody technology that have m ade feasible the generation of human antibodies. This combination of f actors makes passive antibody therapy an option worthy of serious cons ideration. We propose that for every pathogen there exists an antibody that will modify the infection to the benefit of the host. Such antib odies are potential antimicrobial agents. Antibody-based therapies hav e significant advantages and disadvantages relative to standard chemot herapy. The reintroduction of antibody-based therapy would require maj or changes in the practices of infectious disease specialists.