SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

9/30/05

Anti-IgE treatment: anti-inflammatory effects and efficacy

Summary
Background - Omalizumab (Omal), a humanized anti-IgE antibody, has been used extensively in the treatment of moderate to severe allergic asthma and allergic rhinitis. Omal treatment reduces the serum levels of free IgE and down regulates expression of IgE receptors on circulating basophils.

Findings - Holgate et al of several institutions reviewed more recent findings of the biologic effects of Omal treatment. There is a significantly reduction in the frequency of eosinophils and mast cells in nasal and bronchial tissues in Omal treated patients. There is also down regulation of the IgE receptors on circulating (precursor) dendritic cells. This could lead to decreased T cell activation.

More recent studies suggest that asthmatic patients who are the best "responders" to Omal therapy are those with more severe disease. Also, improvement in both nasal and asthmatic symptoms with Omal treatment of those with both allergic rhinitis and allergic asthma points to the central role of IgE in both these disorders.

Reference
Clin Exp Allergy 2005;35:408-16 3

Editor's Comments
These comments by highly respected investigators highlight the rather profound effects of Omal therapy on allergic inflammation in both allergic rhinitis and asthma. The fact that more severe asthma appears to be a better candidate for Omal therapy points to what may be a limited indication for this very expensive therapy.

 

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