Biotechnology 540, August 30, 2007
Case Studies in rDNA drugs

How well do your know your Biotechnology Drugs?

Patient 1: Is a 60-year-old woman who has been rushed to the ER, complaining of pain in the center of her chest that is spreading down her shoulders, neck and arms. A team of emergency room physicians determine that the woman is suffering an Acute Myocardial Infarction (AMI; heart attack), most likely due to a blood clot in her coronary arteries. What medication would likely be administered to this woman to restore blood flow to the heart within minutes of injection? Briefly, how does this medication work?

Patient 2: Is a 50-year-old man with Type I diabetes. He visits his physician because he is concerned about a number of small sores on his feet that do not seem to be healing well. He also saw a TV commercial on a new diabetes medicine, Byetta. He wants to discuss trying Byetta alone or in combination with the Humalog mix he currently takes. What is “Humalog Mix” and would you recommend for this patient’s two concerns?



Patient 3: is undergoing chemotherapy for malignant melanoma. What are two rDNA drug options that drugs might be recommended for this patient? How are they different? Why might Aranesp and Neulasta be prescribed along with the chemotherapy regimen?



Patient 4: Is a 35-year old man admitted to the hospital with bacterial pneumonia. Although a course of IV antibiotics is administered, his symptoms suddenly and rapidly worsen, with loss of consciousness, systemic blood clotting, and indications of multiple organ failure presenting within 4 hours of his admittance. Given the rapid deterioration of the patient’s health, what life-threatening condition would you suspect (other than pneumonia!), and what rDNA medication would you recommend?


Patient 5: Is a 12-year-old girl with Turner's syndrome (45, X0). She is far shorter than her peers, a common feature of Turner's, and her pediatrician predicts her full height will be 4 feet, 8 inches. Her parents would like to investigate treatments that might increase the height of their daughter while she is still growing. What two choices for medication might be indicated for this girl, and as a pediatrician, what are some benefits and drawbacks of this type of treatment that you might discuss with this otherwise healthy young girl - and her concerned parents?



Quick diagnosis! What rDNA meds would be indicated for the following people:

Patient 6: A 50-year old man with chronic plaque psoriasis.

Patient 7: A 9th grade girl in Indiana, before she can be allowed to enter her freshman year in High School, 2007

Patient 8:
A man with a “central line” (central venous access catheter) that has become occluded by a blood clot

Patient 9: A 40-year old patient recently diagnosed with Multiple Sclerosis

Patient 10: A healthy, 22-year old woman, not yet sexually active, who visits her physician for her annual Pap smear

Patient 10: A 70-year old female with osteoporosis


Patients 11-16: Hmmm...what are the chances of this happening?

6 patients are all in a waiting room. One patient has been diagnosed with Malignant melanoma, one with Non-Hodgkin's lymphoma, another with Hairy cell leukemia, still another with Kaposi's sarcoma, one with Chronic hepatitis B (HBV), and a final person with Condylomata acuminata (if you don't know, don't ask!). Amazingly, they find that they are all taking the SAME medication, which is...


Human Growth Hormone: cDNA cloning and expression in Bacteria

1. Who authored this paper? (and what does this have to do with the Midnight Raid of Peter Seeburg and Axel Ullrich?)

2. What human tissue was source of the hGH? (and what is acromegaly?)

3. Why was cDNA used rather than genomic DNA?

4. Conclusions of Figures 3, 4, and Figure 6?

















What is the protein product of this drug?
This drug is prescribed for what indication?
How is this drug similar to the one at left?
How is is different?
A fairly new drug for what indication?
What is the protein product of this drug?

Who would benefit from this drug..and what are the dangers?
What type of recombinant protein is given as the drug?

What are these two drugs? How do they differ?  

(QD - Every day quiaque die; QW - Every week; Q2W - Every 2 weeks; TIW - Three times weekly)



4 million Americans are infected with this disease...and this drug fights it...what disease is it?


Who would benefit from this drug..and how does it work?




June 8, 2006: What did the FDA approve, and what are the protein products? Who will this product help? Tagline: "Are you ready to start Chemotherapy?" ... "Be Ready" What is this drug and what does it do?




What is the protein product of this drug?
Who receives it and when?




Who would benefit from this drug..and why?
What is the protein product?



What is the protein product of this drug? Who would receive it, and are there any dangers in this product? What is the protein product of this drug? How is it new and improved over its older 'sibling'?


This drug is indicated for what condition - and what is the protein product?


Just WHO is Lilly taking care of...and how does it differ from the drug at right?




What is the protein product of this drug?
What is its indication?

What recombinant protein forms the basis of these 3 drugs? What is their indication? How are they similar and different?

Advanced thrombolytic by design

This drug is indicated for what condition - and what is the protein product?

What is the protein product of this drug?
What is its indication?


A bit more detail on the Mechanism of Action (MOA) of some of the drugs:


Mechanism of Action: Interferons and T-cell autoimmune diseases

MOA is unknown, but interferons act by:

  1. Interfering with viral infection by stimulating natural killer cells (NK) cells, T cells, and macrophages [Hep B, Hep C]
  2. Slowing cancer cell growth or causing cancer cells to change into "more normal" cells [NHL, Kaposi, malignant melanoma].
  3. "Calm" or down-regulate the immune system by reducing tissue necrotic factor-alfa (TNF-a) secretion or minimizing T cell lymphoproliferative responses.

*Good website on the differences between Interferons, Interleukins and other "Biologic Therapies"
that help the immune system work better against disease.

Abnormal dendritic cells (antigen presenting cells) show a protein called LFA-3 on their surface. The LFA-3 protein binds to the T-cell CD2 receptor, and prompting the T cells to initiate an inflammation pathway as T-cell "memory effector cells".

The LFA-3 part of the fusion protein binds to the T-cell CD2 receptor (preventing the dendritic cells from binding), and the IgG1 "tail" signals NK cells to seek and destroy the T-cells...way cool! More info

Because Amevive reduces T-cell counts (important for fighting off infections, etc), T-cell levels are monitored closely after treatment MOA

Proleukin in an Interleukin 2, another immune system modulator:
IL-2 activates the immune system in several ways, but the major one is to stimulate T cell and natural killer (NK) cell proliferation.