The structures, antigen binding, and abilities to activate complement are important aspects to understand different drugs relating to autoimmune diseases. Each of the four drugs, infliximab, Adalimumab, Etanercept, and Certilizumab, have different antibody structures, leading to differences in function and binding abilities. The drug infliximab is a chimeric monoclonal antibody, containing 25% mouse-derived and 75% human-derived amino acids. The drug Adalimumab is a fully human monoclonal antibody containing an IgG1 antibody, proficient at complement fixation and Fc-receptor binding. Etanercept is a genetically engineered fusion protein which contains a dimer of human extracellular portions of TNFR2 as well as an Fc portion of human IgG1. Certilizumab is found as a monovalent Fab antibody fragment, which is covalently bonded to polyethylene glycol, but does not contain an Fc region.1
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Infliximab has a strong binding affinity toward soluble TNF (sTNF) and transmembrane TNF (tmTNF) but very weak binding affinity to LT ligands. This drug has very strong actions toward apoptosis, cytokine suppression, CDC, and ADCC. Similar to infliximab, the drug Adalimumab has strong binding affinity toward sTNF and tmTNF and very weak binding affinity toward LT ligands. This drug also has very strong actions toward apoptosis, cytokine suppression, CDC, and ADCC. Etanercept has very strong binding affinity to both TNF ligands as well as the two LT ligands of LT3 and LT21. This drug only has moderate to very weak actions toward reverse signaling, CDC, and ADCC. The last drug, Certilizumab, only has strong binding affinity toward the two TNF ligands. The drug has very strong actions toward cytokine suppression, however very weak actions toward apoptosis, CDC, and ADCC.
Infliximab has a strong binding affinity toward soluble TNF (sTNF) and transmembrane TNF (tmTNF) but very weak binding affinity to LT ligands. This drug has very strong actions toward apoptosis, cytokine suppression, CDC, and ADCC. Similar to infliximab, the drug Adalimumab has strong binding affinity toward sTNF and tmTNF and very weak binding affinity toward LT ligands. This drug also has very strong actions toward apoptosis, cytokine suppression, CDC, and ADCC. Etanercept has very strong binding affinity to both TNF ligands as well as the two LT ligands of LT3 and LT21. This drug only has moderate to very weak actions toward reverse signaling, CDC, and ADCC. The last drug, Certilizumab, only has strong binding affinity toward the two TNF ligands. The drug has very strong actions toward cytokine suppression, however very weak actions toward apoptosis, CDC, and ADCC.