IgE-Related Chronic Diseases and Anti-IgE-Based Treatments

J Immunol Res. 2016:2016:8163803. doi: 10.1155/2016/8163803. Epub 2016 Dec 21.

Abstract

IgE is an immunoglobulin that plays a central role in acute allergic reactions and chronic inflammatory allergic diseases. The development of a drug able to neutralize this antibody represents a breakthrough in the treatment of inflammatory pathologies with a probable allergic basis. This review focuses on IgE-related chronic diseases, such as allergic asthma and chronic urticaria (CU), and on the role of the anti-IgE monoclonal antibody, omalizumab, in their treatment. We also assess the off-label use of omalizumab for other pathologies associated with IgE and report the latest findings concerning this drug and other new related drugs. To date, omalizumab has only been approved for severe allergic asthma and unresponsive chronic urticaria treatments. In allergic asthma, omalizumab has demonstrated its efficacy in reducing the dose of inhaled corticosteroids required by patients, decreasing the number of asthma exacerbations, and limiting the effect on airway remodeling. In CU, omalizumab treatment rapidly improves symptoms and in some cases achieves complete disease remission. In systemic mastocytosis, omalizumab also improves symptoms and its prophylactic use to prevent anaphylactic reactions has also been discussed. In other pathologies such as atopic dermatitis, food allergy, allergic rhinitis, nasal polyposis, and keratoconjunctivitis, omalizumab significantly improves clinical manifestations. Omalizumab acts in two ways: by sequestering free IgE and by accelerating the dissociation of the IgE-Fcε receptor I complex.

Publication types

  • Review

MeSH terms

  • Anaphylaxis / prevention & control
  • Anti-Allergic Agents / therapeutic use*
  • Anti-Asthmatic Agents / therapeutic use*
  • Antibodies, Anti-Idiotypic / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Asthma / drug therapy*
  • Humans
  • Immunoglobulin E / immunology*
  • Off-Label Use
  • Omalizumab / therapeutic use*
  • Receptors, IgE / immunology
  • Urticaria / drug therapy*

Substances

  • Anti-Allergic Agents
  • Anti-Asthmatic Agents
  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal
  • Receptors, IgE
  • anti-IgE antibodies
  • Omalizumab
  • Immunoglobulin E