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Incivility of passive immunity

Gerald M. Higa*, Katie Murto

Survival of the fetus and newborn is not possible without vital immune components. The immune repertoire includes a cadre of innate factors sheltered in the intrauterine domicile as well as maternally-sourced humoral elements. The latter, known as passive immunity, refer to maternal antibodies that mediate vigilant immune surveillance during gestation and for a few months after birth. While immunologically beneficial, their therapeutic luster is tarnished somewhat by a number of antibody-associated abnormalities that have been reported in offsprings. And though basic science tenets of the antibody transfer process are well accepted, the immuno-biochemical mechanisms related to the therapeutic and pathogenic effects remain incompletely understood. This opinion-based paper provides reasoned insight regarding the bi-functionality of immunoglobulins by focusing on maternal benefit, and potential in utero detriment, of a recombinant monoclonal antibody used in the treatment of one breast cancer subtype. If valid, this concept may be applicable to other engineered antibodies.