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Biotherapeutics is a rapidly growing segment of the entire pharmaceutical industry that constitutes approximately one-quarter of ongoing new drug endorsements. Monoclonal antibodies are a major part of these endorsements every year (mAbs). MAbs' non-clinical pharmacology and toxicology research compare with substance components during progression, since these biotherapeutics are extracted from an organic source, and to inspire a pharmacological reaction, the creature models must also have similar epitopes (focuses) as individuals. Biotherapeutic items (BTPs) are the quickest developing drugs in the pharmaceutical market. Despite their clinical achievement, the immunogenicity of BTPs keeps on being a significant concern. The subcutaneous (SC) course is to cultivate a passion for the organisation of biotherapeutics. Both monoclonal antibodies and various biotherapeutics are discussed. Medicine has been disrupted by biotherapeutic drugs (BPs), altering the way we treat a few processes. Comparative BPs (SBPs) are discussed here, also called biosimilars, including the assembly process and administrative viewpoints used. Monoclonal antibodies can apply synergistic antitumour impacts in blend with other immunomodulatory approaches, for example, chemotherapy, radiotherapy, directed treatment specialists, immunisations, or different immunomodulators. Probiotics have gotten profoundly perceived as enhancements for people and specifically for creatures given their gainful result on wellbeing improvement and prosperity support.


Biotherapeutics pharmaceutical immunogenicity probiotics microbiology

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Kaur, N., & Chaudhary, . V. (2021). Biotherapeutics and its applications in Microbiology. Environment Conservation Journal, 22(SE), 63–78.


  1. Adams, S. D. and Mercer, D. W. 2007. Fulminant Clostridium difficile colitis. Current Opinion in Critical Care, 13: 450-55.
  2. Adelman, J. 2019. New Navy Yard lab and office complex planned for Calif. cell-therapy research firm Iovance. The Philadelphia Inquirer.
  3. Al-Ghazzewi, F. H. and Tester, R. 2014. Inhibition of the adhesion of Escherichia coli to human epithelial cells by carbohydrates. Bioactive Carbohydrates and Dietary Fibre, 4 :1-5.
  4. Al-Ghazzewi, F. H. and Tester, R. F. 2010. Effect of konjac glucomannan hydrolysates and probiotics on the growth of the skin bacterium Propionibacterium acnes in vitro. International Journal of Cosmetic Science, 32: 139-142.
  5. Anukam, K. C., Osazuwa, E., Osemene, G. I., Ehigiagbe, F., Bruce, A. W. and Reid, G. 2006. Clinical study comparing probiotic Lactobacillus GR-1 and RC-14 with metronidazole vaginal gel to treat symptomatic bacterial vaginosis. Microbes Infection, 8: 2772-2776.
  6. Anukam, K., Osazuwa, E., Ahonkhai, I., Ngwu, M., Osemene, G., Bruce, A. W. and Reid, G. 2006. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infection, 8: 1450-1454.
  7. Apgar, J. F., Wong, J., Phennicie, R., Briskin, M. and Burke, J. M. 2016. Abstract B34: Quantitative systems pharmacology and immunotherapy: accelerating lead generation and optimization of a PD-1 x TIM-3 biotherapeutic in immuno-oncology.
  8. Bae, Y. H. and Park, K. 2011. Targeted drug delivery to tumors: myths, reality and possibility. Journal of controlled release, 153(3): 198.
  9. Bartlett, J. G. 2006. Narrative review: the new epidemic of Clostridium difficile-associated enteric disease. Annals of Internal Medicine, 145: 758-764.
  10. Bartlett, J. G., Chang, T. W., Gurwith, M., Gorbach, S. L. and Onderdonk, A. B. 1978. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. The New England Journal of Medicine, 298: 531-534.
  11. Beck, A. 2011. Biosimilar, biobetter and next generation therapeutic antibodies. Monoclonal Antibodies, 3(2): 107-110.
  12. Becker, H. and Reichert, J. M. 2007. Muromonab?CD3 (Orthoclone OKT3). Handbook of therapeutic antibodies, 905-940.
  13. Bhutiani, R. and Ahamad, F. 2019. A case study on changing pattern of agriculture and related factors at Najibabad region of Bijnor, India. In: Contaminants in Agriculture and Environment: Health Risks and Remediation. Edited by Vinod Kumar, Rohitashw Kumar, Jogendra Singh and Pankaj Kumar (ISBN: 978-81-942017-0-0). DOI: 10.26832/AESA-2019-CAE-0158-018, pp 237-247.
  14. Bibeau, F. 2009. Impact of Fc?RIIa–Fc?RIIIa polymorphisms and KRaS mutations on the clinical outcome of patients with metastatic colorectal cancer treated with cetuximab plus irinotecan. International Journal of Clinical Oncology, 27: 1122-1129.
  15. Bloch, E. F., Schultz, R. D. and Turner, W. 2013. Mini-review: Probiotics and disease prevention in different host systems. Microbiology Research Journal International, 42-57.
  16. Bonin-Debs, A. L., Boche, I., Gille, H. and Brinkmann, U. 2004. Development of secreted proteins as biotherapeutic agents. Expert opinion on biological therapy, 4(4): 551-558.
  17. Bou-Antoun, S. 2008. Compositions that aim to promote the development and growth of a bene?cial vaginal micro?ora. European Patent EP, 2303300.
  18. Brazier, J. S. 2008. Clostridium difficile: from obscurity to superbug. British Journal of Biomedical Science, 65: 39-44.
  19. Brzozowski, T., Zwolinska-Wcislo, M.and Konturek, P. C. 2005. In?uence of gastric colonization with Candida albicans on ulcer healing in rats: effect of ranitidine, aspirin and probiotic therapy. Scandinavian Journal of Gastroenterol, 40: 286-296.
  20. Cartron, G. 2002. Therapeutic activity of humanized anti-CD20 monoclonal antibody and polymorphism in IgG Fc receptor Fc?RIIIa gene. Blood, 99: 754-758.
  21. Chaplin, D. D. 2010. Overview of the immune response. Journal of Allergy and Clinical Immunology, 125(2): 3-23.
  22. Clement, S., Still, J. G., Kosutic, G. and McAllister, R. G. 2002. Oral insulin product hexyl-insulin monoconjugate 2 (HIM2) in type 1 diabetes mellitus: the glucose stabilization effects of HIM2. Diabetes technology & therapeutics, 4(4): 459-466.
  23. Clynes, R. A., Towers, T. L., Presta, L.G. and Ravetch, J. V. 2000. Inhibitory Fc receptors modulate in vivo cytoxicity against tumor targets. Nature Medicine, 6: 443-446.
  24. Coiffier, B. 2008. Safety and efficacy of ofatumumab, a fully human monoclonal anti-CD20 antibody, in patients with relapsed or refractory b-cell chronic lymphocytic leukemia: a phase 1–2 study. Blood, 111: 1094-100.
  25. Coman, M. M., Verdenelli, M. C. and Cecchini, C. 2014. In vitro evaluation of antimicrobial activity of Lactobacillus rhamnosus IMC 501®, Lactobacillus paracasei IMC 502® and SYNBIO® against pathogens. Journal of Applied Microbiol, 117: 518-527.
  26. Coste, I., Judlin, P., Lepargneur, J. P. and Bou-Antoun, S. 2012. Safety and ef?cacy of an intravaginal prebiotic gel in the prevention of recurrent bacterial vaginosis: a randomised double-blind study. International Journal of Obstetrics and Gynecology, 147867.
  27. Cragg, M.S.and G.lennie, M. J. 2004. Antibody specificity controls in vivo effector mechanisms of anti-CD20 reagents. Blood,103: 2738-2743.
  28. Dale, E. and Johnson. 2018. Biotherapeutics: Challenges and opportunities for predictive toxicology of monoclonal antibodies.International Journal of Molecular Sciences, doi:10.3390/ijms19113685.
  29. Decker, E. L. and Reski, R. 2008. Current achievements in the production of complex biopharmaceuticals with moss bioreactors. Bioprocess and Biosystems Engineering, 31(1): 3-9.
  30. Demirel, G., Celik, I. H., Erdeve, O., Saygan, S., Dilmen, U. and Canpolat, F. E. 2013. Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. European Journal of Pediatrics, 172: 1321-1326.
  31. Di Gaetano, N. 2003. Complement activation determines the therapeutic activity of rituximab in vivo. Journal of Immunology, 171: 1581-1587.
  32. Dove, A. 2000. Milking the genome for profit. Nature Biotechnology, 18(10): 1045-1048.
  33. Dranitsaris, G., Amir, E. and Dorward, K. 2011. Biosimilars of biological drug therapies. Drugs, 71(12): 1527-1536.
  34. Elmer, G. W., Surawicz, C. M. and McFarland, L. V. 1996. Biotherapeutic agents: a Neglected modality for the treatment and prevention of selected intestinal and vaginal infections. Journal of the American Medical Association, 275: 870-876.
  35. EMA 2008. Questions and answers on biosimilar medicines (similar biological medicinal products) . Dc. Ref. EMEA/74562/2006 Rev. 1
  36. Garber Ken 2019. "Pursuit of tumor-infiltrating lymphocyte immunotherapy speeds up". Nature Bio, 37:969-977
  37. Gerding, D. N. 2012. Clostridium difficile infection prevention: biotherapeutics, immunologics, and vaccines. Discovery medicine, 13(68): 75-83.
  38. Giannasca, P. J., Zhang, Z. X., Lei, W. D., Boden, J. A., Giel, M. A., Monath, T. P. and Thomas, W. D. 1999. Serum antitoxin antibodies mediate systemic and mucosal protection from Clostridium difficile disease in hamsters. Infection and Immunity, 67(2): 527-538.
  39. Golay, J. and Introna, M. 2012. Mechanism of action of therapeutic monoclonal antibodies: promises and pitfalls of in vitro and in vivo assays. Archives of biochemistry and biophysics, 526(2):146-153.
  40. Gouilleux, F., Pallard, C., DusanterFourt, I., Wakao, H., Haldosen, L. A., Norstedt, G. and Groner, B. 1995. Prolactin, growth hormone, erythropoietin and granulocyte macrophage colony stimulating factor induce MGF Stat5 DNA binding activity. The EMBO journal, 14(9): 2005-2013.
  41. Hantoushzadeh, S., Golshahi, F., Javadian, P., Khazardoost, S., Aram, S., Hashemi, S., Mirarmandehi, B. and Borna, S. 2012. Comparative ef?cacy of probiotic yoghurt and clindamycin in treatment of bacterial vaginosis in pregnant women: a randomised clinical trial. Journal of Matenal- Fetal Neonatal Medicine, 25: 1021-1024.
  42. Harper, D. R., Burrowes, B. H. and Kutter, E. M. 2014. Bacteriophage: therapeutic uses. eLS.
  43. Hasslöf, P., Hedberg, M., Twetman, S. and Stecksen-Blicks, C. 2010. Growth inhibition of oral mutans streptococci and candida by commercial probiotic lactobacilli-an in vitro study. BMC Oral Health,10-18.
  44. Hemmerling, A., Harrison, W., Schroeder, A., Park, J., Korn, A., Shiboski, S., Foster-Rosales, A. and Cohen, C. R. 2010. Phase 2a study assessing colonization ef?ciency, safety, and acceptability of Lactobacillus crispatus CTV-05 in women with bacterial vaginosis. Sexually Transmitted Diseases, 37: 745-750.
  45. Henson, E., Chen, Y. and Gibson, S. 2017. EGFR family members’ regulation of autophagy is at a crossroads of cell survival and death in cancer. Cancers, 9(4): 27.
  46. Hou, W., Han, L., Li, M., Chen, J. and Chen, Y. 2014. Effectiveness evaluation of alginate oligosaccharides antibacterial gel for bacterial vaginosis. Journal of Life Sciences, 11: 528-531.
  47. Hristea, I. and Khalili, V. 2000. Alteplase (TPA) for clotted dialysis catheters. 668-669.
  48. Hurley, B. W. and Nguyen, C. C. 2002. The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea. Archievesof Internal Medicine, 162: 2177-2184.
  49. Jones, M. L., Tomaro-Duchesneau, C., Martoni, C. J. and Prakash, S. 2013. Cholesterol lowering with bile salt hydrolase-active probiotic bacteria, mechanism of action, clinical evidence, and future direction for heart health applications. Expert OpinonBiological Therapy, 13: 631-642.
  50. Kay, J. 2011. Biosimilars: a regulatory perspective from America. Arthritis Research &Therapy, 13(3): 112.
  51. Kerr, L. D. 2010. The use of biologic agents in the geriatric population. Journal of Musculoskeletal Medicine, 27: 175-180.
  52. Khalesi, S., Sun, J., Buys, N. and Jayasinghe, R. 2014. Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials. Hypertension, 64: 897-903.
  53. Khalil, H. and Huang, C. 2020. Adverse drug reactions in primary care: a scoping review. BMC Health Services Research, 20(1): 5.
  54. Lehtoranta, L., Pitkaranta, A. and Korpela, R. 2014. Probiotics in respiratory virus infections. European Journal of Clinical Microbiology & Infectious Diseases, 33: 1289-1302.
  55. Lenoir-Wijnkoop, I., Sanders, M. E., Cabana, M. D., Caglar, E., Corthier, G., Rayes, N., Sherman, P. M. and Timmerman, H. M. 2007. Probiotic and prebiotic in?uence beyond the intestinal tract. Nutrition Reviews, 65: 469-489.
  56. Li, D., Li, Q. and Liu, C. 2014. Ef?cacy and safety of probiotics in the treatment of Candida-associated stomatitis. Mycoses, 57: 141-146.
  57. Linhares, L. M., Kanninen, T., Orfanelli, T., Jayaram, A., Doulaveris, G. and Witkin, S. S. 2013. The vaginal microbiome: new ?ndings bring new opportunities. Drug Development Research, 74: 360-364.
  58. Lundin, J. 2002. Phase II trial of subcutaneous antiCD52 monoclonal antibody alemtuzumab (Campath1H) as first-line treatment for patients with b-cell chronic lymphocytic leukemia (b-CLL). Blood, 100: 768-773.
  59. McFarland, L. V. and Elmer, G. W. 1995. Biotherapeutic agents: past, present and future. MicroecolTher. 23: 46 -73.
  60. Maggi, L., Mastromarino, P., Macchia, S., Brigidi, P., Pirovano, F., Matteuzzi, D. and Conte, U. 2000. Technological and biological evaluation of tablets containing different strains of lactobacilli for vaginal administration. European Journal of Pharmaceuticals and Biopharmaceuticals, 50: 389-395.
  61. Maitra, A., Rollins, M., Tran, L., Al-Ghazzewi, F. and Tester, R. 2013. Prebiotic konjac glucomannan hydrolysate reduces Streptococcus mutans in oral bio?lms. International Association for Dental Research (IADR) Abstracts. March 20-23, Seattle, Washington, USA.
  62. Mandell, D. J., Lajoie, M. J., Mee, M. T., Takeuchi, R., Kuznetsov, G., Norville, J. E. and Church, G. M. 2015. Biocontainment of genetically modified organisms by synthetic protein design. Nature, 518 (7537): 55-60.
  63. Manzoni, P., Mostert, M. and Leonessa, M. L. 2006. Oral supplementation with Lactobacillus casei sub species rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clinical Infectious Disease, 42: 1735-1742.
  64. Martinez, R. C., Franceschini, S. A. and Patta, M. C. 2009. Improved treatment of vulvovaginal candidiasis with ?uconazole plus probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Letters in Applied Microbiology, 48: 269-274.
  65. Medzhitov, R. 2007. Recognition of microorganisms and activation of the immune response. Nature, 449 (7164): 819-826.
  66. Musolino, A. 2008. Immunoglobulin G. fragment C receptor polymorphisms and clinical efficacy of trastuzumab-based therapy in patients with HER-2/ neu-positive metastatic breast cancer. Journal of Clinical Oncology, 26: 1789-1796.
  67. Nasioudis, D., Beghini, J., Bongiovanni, A. M., Giraldo, P. C., Linhares, I. M. and Witkin, S. S. 2015. a-Amylase in vaqginal ?uid: association with conditions favourable to dominance of Lactobacillus. Reproductive Sciences, 22: 1393-1398.
  68. Neri, A., Sabah, G. and Samra, Z. 1993. Bacterial vaginosis in pregnancy treated with yoghurt. Acta Obstetricia Gynecologica Scandinavica, 72: 17-19.
  69. Nick, C. 2012. The US Biosimilars Act: Challenges Facing Regulatory Approval. Pharmacy Medical, 26(3): 145-152.
  70. Ozaki, E., Kato, H. and Kita, H. 2004. Clostridium difficile colonization in healthy adults: transient colonization and correlation with enterococcal colonization. Journal of Medical Microbioloh, 53: 167-172.
  71. Petricevic, L. and Witt, A. 2008 . The role of Lactobacillus caseirhamnosusLcr 35 in restoring the normal vaginal ?ora after antibiotic treatment of bacterial vaginosis. British Journal of Obstetrics Gynaecology, 115: 1369-1374.
  72. Phillip, B. C. Jones. 2006. European Regulators Curdle Plans for Goat Milk Human Antithrombin.
  73. Pombo, M. L., Di Fabio, J. L. and Cortes Mde, L. 2009. Review of regulation of biological and biotechnological products in Latin American and Caribbean countries. Biologicals, 37(5): 271-276.
  74. Racila, E. 2008. A polymorphism in the complement component C1qa correlates with prolonged response following rituximab therapy of follicular lymphoma. Clinical Cancer Research, 14: 6697-6703.
  75. Reid, G., Beuerman, D., Heinemann, C. and Bruce, A. W. 2001. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal ?ora. Federation of European Microbiological Societies Immunology & Medical Microbiology, 32: 37-41.
  76. Reid, G., Charbonneau, D., Erb, J., Kochanowski, B., Beuerman, D., Poehner, R., Poehner, R. and Bruce, A. W. 2003. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 signi?cantly alters vaginal ?ora: randomised, placebo-controled trial in 64 healthy women. Federation of European Microbiological Societies Immunology & Medical Microbiology, 35:131-134.
  77. Roberfroid, M. B. 2007. Prebiotics: the concept revisited. Journal of Nutrition, 137: 830-837.
  78. Roger, S. D. 2010. Biosimilars: current status and future directions. Expert Opinion on Biological Therapy, 10(7): 1011-1018.
  79. Romeo, M. G., Romeo, D. M. and Trovato, L. 2011. Role of probiotics in the prevention of the enteric colonization by Candida in preterm newborns: incidence of late-onset sepsis and neurological outcome. Journal of Perinatology, 31: 63-69.
  80. Rousseau, V., Lepargneur, J. P., Roques, C., Remaud-Simeon, M. and Paul, F. 2005. Prebiotic effects of oligosaccharides on selected vaginal lactobacilli and pathogenic microorganisms. Anaerobe, 11: 145-153.
  81. Roy, A., Chaudhuri, J., Sarkar, D., Ghosh, P. and Chakraborty, S. 2014. Role of enteric supplementation of probiotics on late-onset sepsis by Candida species in preterm low birth weight neonates: a randomized, double blind, placebo-controlled trial. North American Journal of Medical Sciences, 6: 50-57.
  82. Saarela, M., Mogensen, G., Fonden, R., Matto, J. and Mattila-Sandholm, T. 2000. Probiotic bacteria: safety, functional and technological properties. Journal of Biotechnology, 84: 197-215.
  83. Sardi, J. C., Scorzoni, L., Bernardi, T., Fusco-Almeida, A. M. and Mendes Giannini, M. J. 2013. Candida species: current epidemiology, pathogenicity, bio?lm formation, natural antifungal products and new therapeutic options. Journal of Medical Microbiology, 62(1): 10-24.
  84. Sarkar, S. 2007. Functional foods as self-care and complementary medicine. Nutration Food Science, 37: 160-167.
  85. Sarkisov, S. E., Krymshokalova, Z. S., Kafarskaia, L. I. and Korshunov, V. M. 2000. The use of biotheraputic agent Zhlemilk for correcting the micro?ora in bacterial vaginosis. Journal of Microbiology, Epidemiology and Immunobiology, 1: 88 -90.
  86. Sarkisov, S.E., Krymshokalova, Z.S., Kafarskaia, L.I. and
  87. Shanahan, F., Stanton, C., Ross, P. and Hill, C. 2009. Pharmabiotics: bioactive from mining host-microbedietary interactions. Functional Food Reviews, 1: 20-25.
  88. Shida, K. and Nomoto, K. 2013. Probiotics as ef?cient immunopotentiators: translational role in cancer prevention. Indian Journal of Medical Research, 138: 808-814.
  89. Siddiqui F, O’Connor, J. R., Nagaro, K., Adam,Cheknis., Sambol, S. P., Vedantam, G., Gerding, D. N.and Johnson, S. 2011. Vaccination with parenteral toxoid B protects hamsters against lethal challenge with toxin A-negative, toxin B-positive Clostridium difficile but does not prevent colonization. Journal of Infectious Diseases, epub ahead of print.
  90. Sleytr, U. B., Sára, M., Pum, D. and Schuster, B. 2001. Characterization and use of crystalline bacterial cell surface layers. Progress in Surface Science, 68(7-8): 231-278.
  91. Spear, G. T., McKenna, M., Landay, A. L., Makinde, H., Hamaker, B., French, A. L. and Lee, B. H. 2015. Effect of pH on cleavage of glycogen by vaginal enzymes. PLoS One, 10, e0132646.
  92. Strus, M., Kucharska, A., Kukla, G., Brzychczy-Wloch, M., Maresz, K. and Heczko, P. B. 2005. The in vitro activity of vaginal Lactobacillus with probiotic properties against Candida. Infectious Diseases in Obstetrics and Gynecology, 13: 69-75.
  93. Sutherland, A., Tester, R., Al-Ghazzewi, F., McCulloch, E. and Connolly, M. 2008. Glucomannan hydrolysate (GMH) inhibition of Candida albicans growth in the presence of Lactobacillus and Lactococcus species. Microbial Ecology in Healthand Disease, 20: 127-134.
  94. Tester, R. F. and Al-Ghazzewi, F. H. 2011. A preliminary study of the synbiotic effects of konjac glucomannan hydrolysates (GMH) and lactobacilli on the growth of the oral bacterium Streptococcus mutans. Nutrition and Food Science, 41: 234-237.
  95. Tester, R. F. and Al-Ghazzewi, F. H. 2016. Bene?cial health characteristics of native and hydrolysed konjac (Amorphophalus konjac) glucomannan. Journal of the Science of Food and Agriculture, doi: 10.1002/jsfa.7571.
  96. Tester, R., Al-Ghazzewi, F., Shen, N., Chen, Z., Chen, F., Yang, J., Zhang, D. and Tang, M. 2012. The use of konjac glucomannan hydrolysates to recover healthy microbiota in infected vaginas treated with an antifungal agent. Beneficial Microbes, 3: 61-66.
  97. Torres, J. F., Lyerly, D. M., Hill, J. E. and Monath, T. P. 1995. Evaluation of formalin-inactivated Clostridium difficile vaccines administered by parenteral and mucosal routes of immunization in hamsters. Infection and Immunity, 63 (12): 4619-4627.
  98. Turovskiy, Y., SutyakNoll, K. and Chikindas, M. L. 2011 The aetiology of bacterial vaginosis. Journal of AppliedMicrobiology, 110: 1105-1128.
  99. Verdenelli, M. C., Coman, M. M., Cecchini, C., Silvi, S., Orpianesi, C. and Cresci, A. 2014. Evaluation of anti pathogenic activity and adherence properties of human Lactobacillus strains for vaginal formulations. Journal of AppliedMicrobiology, 116: 1297-1307.
  100. Vilela, S. F., Barbosa, J. O. and Rossoni, R. D. 2015. Lactobacillus acidophilus ATCC 4356 inhibitsbio?lmformationbyC.albicansandattenuatestheexperimentalcandidiasis in Galleria mellonella. Virulence, 6: 29-39.
  101. Villamor, N., Montserrat, E. and Colomer, D. 2003. Mechanism of action and resistance to monoclonal antibody therapy. In Seminars in oncology, 30 (4): 424-433.
  102. Von Schwerin, A., Stoff, H. and Wahrig, B. 2015. Biologics, a history of agents made from living organisms in the twentieth century. Routledge.
  103. Wang, S. Y. 2009. Depletion of the C3 component of complement enhances the ability of rituximabcoated target cells to activate human NK cells and improves the efficacy of monoclonal antibody therapy in an in vivo model. Blood, 4: 5322-5330.
  104. Weng, W. K. and Levy, R. 2003. Two immunoglobulin G. fragment C receptor polymorphisms independently predict response to rituximab in patients with follicular lymphoma. Journal of Clinical Oncology, 21: 3940-3947.
  105. Zalevsky, J. 2009. The impact of Fc engineering on an anti-CD19 antibody: increased Fc? receptor affinity enhances b-cell clearing in nonhuman primates. Blood, 11. 3735-3743.