By S.H. Arshad, K. Suresh Babu, Stephen Holgate
Little new has been brought into the armamentarium for bronchial asthma remedy within the final thirty years except advancements in b2-adrenoceptor agonists, corticosteroids and cysteinyl leukotriene antagonists. besides the fact that, the creation of an absolutely humanised monoclonal antibody to immunoglobulin E (IgE) (omalizumab), should still supply a brand new approach of treating allergic issues, with results that stretch past a unmarried affected organ and tissue. the ideal function of this new agent in remedy guidance might want to be rigorously evaluated, yet its transparent efficacy and security offer a robust assertion in regards to the value of IgE around the complete spectrum of allergic disorder. This pocketbook offers an illustrative precis of the position of IgE within the pathogenesis of bronchial asthma and allied allergic problems, in addition to the consequences of anti-IgE treatment within the administration of those stipulations.
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Additional info for Anti-IgE Therapy in Asthma and Allergy
More than a decade ago, rabbit-derived polyclonal anti-IgE antibodies given to mice were found to dramatically reduce IgE levels in serum and suppress the number of IgE-producing B-cells. Treatment of mice with a 37 single injection of an anaphylactogenic anti-IgE monoclonal antibody (MAb) during primary immunization reduced serum IgE, but not IgG, to undetectable levels for over 2 months, even when the animals were exposed to antigen on a weekly basis. With the development of techniques to produce MAb, a nonanaphylactogenic murine MAb that binds to circulating IgE at the same site as the high-affinity receptor has been developed.
Therefore, the clinical trials on anti-IgE will need to monitor the incidence of parasitic infections in patients treated with anti-IgE. The humanization of the antibody and the small size of IgE/anti-IgE complexes are expected to prevent an immune response. This size corresponds to that of human IgM, and such complexes are unable to activate complement. A weak antigenic reaction was measured in only one of the subjects treated with the chimeric antibody CGP 51901 and in none of the subjects treated with the humanized omalizumab.
Asthma In the treatment of asthma, omalizumab has exhibited a prolonged pharmacological effect without inducing anaphylaxis, blunted the early- and late-phase responses to inhaled allergen, reduced the symptoms of asthma and reduced corticosteroid use. However, the optimum duration of treatment with anti-IgE is not clear. The initial findings suggest that patients with asthma where the corticosteroid usage had been reduced with anti-IgE treatment reverted back to their initial status after discontinuation of treatment.