Example of biomarker-based selection of patients for ADC treatment. DOI: 10.1200/EDBK_431766
Antibody biomarkers are used in biomedical research and clinical diagnostics to identify disease, guide targeted therapy, or monitor for re-occurrence. Biomarkers are typically discovered and subsequently characterized from disease-relevant animal models.
Antibodies are particularly suited as biomarkers for the prediction of disease due to relative ease in measuring from body fluids through various immunoassays, as well as from tissue biopsies with immunohistochemical visualization.1,2
Antibody Biomarkers in Disease Detection and Management
By targeting specific proteins or molecules associated with disease states, antibody biomarkers offer insights into the onset and progression of conditions like cancer, autoimmune disorders, and infectious diseases. For example, in oncology, certain antibodies can target tumor-associated antigens (TAAs), which are proteins expressed at higher levels in cancer cells than in normal cells. The detection of TAAs through antibody biomarkers aids in early cancer detection, prognosis determination, and even in assessing treatment efficacy.
For autoimmune diseases, autoantibodies—antibodies directed against the body’s own proteins—serve as biomarkers to diagnose and understand diseases such as rheumatoid arthritis or lupus. Detecting autoantibodies provides information on disease severity and helps clinicians anticipate potential disease flare-ups, guiding tailored therapeutic interventions.
Biomarker Development
The development of antibody biomarkers begins with discovery, often in preclinical disease models or directly from patient samples. Researchers typically use animal models that replicate aspects of the disease, allowing them to identify potential biomarkers in a controlled environment before validating these markers in human samples. For instance, in animal models of Alzheimer’s disease, antibodies targeting amyloid-beta plaques are explored to develop biomarkers that could eventually be used for early detection and monitoring of the disease in humans.
Once a potential biomarker is discovered, it undergoes a rigorous validation process, which includes verifying its specificity, sensitivity, and reliability across different populations. High specificity ensures the biomarker is unique to a particular disease, reducing the chances of false positives, while sensitivity confirms its ability to detect disease presence at early stages. The validation process is crucial for bringing antibody biomarkers into clinical settings, where they can be used for diagnostic purposes and to guide treatment decisions.
Immunoassays
Immunoassays are essential laboratory methods for detecting antibody biomarkers due to their precision and flexibility in measuring biomarker levels in blood, saliva, and other body fluids. Enzyme-linked immunosorbent assay (ELISA) is one of the most widely used immunoassays in both research and clinical diagnostics. This method involves attaching an antibody to a solid surface, which captures the biomarker of interest from the sample. A secondary, enzyme-linked antibody is then introduced, which binds to the biomarker and produces a measurable signal, often through a color change.
Other immunoassay platforms include chemiluminescent immunoassays (CLIA) and radioimmunoassays (RIA), which offer high sensitivity and are suitable for detecting low-abundance biomarkers. Multiplex immunoassays, which can measure multiple biomarkers simultaneously, are also increasingly popular. These allow researchers and clinicians to analyze complex biomarker panels, which is especially useful for diseases like cancer, where multiple biomarker measurements can provide a more comprehensive diagnostic profile.
References:
Pollak, T. A., Rogers, J. P., Nagele, R. G., Peakman, M., Stone, J. M., David, A. S., & McGuire, P. (2019). Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders. Schizophrenia Bulletin, 45(1), 233-246. https://doi.org/10.1093/schbul/sby021
Howat, W. J., Lewis, A., Jones, P., Kampf, C., Pontén, F., Van der Loos, C. M., Gray, N., Womack, C., & Warford, A. (2014). Antibody validation of immunohistochemistry for biomarker discovery: Recommendations of a consortium of academic and pharmaceutical based histopathology researchers. Methods, 70(1), 34-38. https://doi.org/10.1016/j.ymeth.2014.01.018
