Promiscuous, sheep, and more about monoclonal antibodies

Brendan, Joanna, and immunologist Dr. Paul Ibbett continue their deep dive into biologics, the immune system, and Brendan's treatment journey.

What's covered

• Demyelination explained — and why Brendan's optic-nerve-only damage points away from MS
• How the brain and immune system talk to each other (featuring a spawning salmon and a very over-enthusiastic ram)
• A new vagus-nerve implant that acts like a "snooze button" on TNF-alpha
• Why biologics cost so much — manufacturing in giant bioreactors, ~$1bn per approved drug, and the NHS vs. private cost question (Brendan paid £3,000 per Rituximab infusion privately)
• Bispecific antibodies — the next frontier, especially in cancer
• The future: sequencing patient immune systems and using AI/ML to pick the right drug
• Could biologics ever be injected directly into the CSF? Possibly, but not without certainty about the target