Advertisement

Anti-IgE in Allergic Airway Diseases: Indications and Applications

  • Jennifer Preston DeMore
  • William W. Busse
Part of the Allergy Frontiers book series (ALLERGY, volume 5)

IgE plays a role in both the initial sensitization to antigen and the subsequent effects upon repeat exposure. For sensitization, inhaled antigen is ingested by antigen presenting dendritic cells that line the airway, and then processed and presented to antigen-specific T cells. The subsequent production of cytokines stimulates B cells to produce antigen-specific IgE, which then binds to the surface of mast cells and basophils via the high-affinity receptor for IgE, namely Fc εRI [1] (Fig. 1a).

Upon repeat exposure to an inhaled antigen, there is cross-linking of IgE bound to the surface of mast cells and basophils. This interaction signals mast cells and basophils to degranulate, releasing mediators such as histamine, prostaglandin, and leukotrienes, and to stimulate chemokine and cytokine production. These mediators cause an early or acute phase reaction and, under some circumstances, can lead to a late-phase reaction.

Keywords

Allergic Rhinitis Allergy Clin Immunol Allergic Asthma Seasonal Allergic Rhinitis Allergic Airway Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Strunk RC, Bloomberg GR (2006) Omalizumab for asthma. N Engl J Med 354:2689–95CrossRefPubMedGoogle Scholar
  2. 2.
    Avila PC (2007) Does anti-IgE therapy help in asthma? Efficacy and controversies. Annu Rev Med 58:36.1–19CrossRefGoogle Scholar
  3. 3.
    Boulet LP, Chapman KR, Cote J, Kaira S, Bhagat R, Swystun VA, Laviolette M, Cleland LD, Deschesnes F, Su JQ, DeVault A, Fick RB Jr, Cockcroft DW (1997) Inhibitory effects of an anti-IgE antibody E25 on allergen-induced early asthmatic response. Am J Respir Crit Care Med 155:1835–40PubMedGoogle Scholar
  4. 4.
    Fahy JV, Fleming HE, Wong HH, Liu JT, Su JQ, Reimann J, Fick RB Jr, Boushey HA (1997) The effect of an anti-IgE monoclonal antibody on the early- and late-phase responses to allergen inhalation in asthmatic subjects. Am J Respir Crit Care Med 155:1828–34PubMedGoogle Scholar
  5. 5.
    Corren J, Froehlich J, Schoenhoff M, Spectgor S, Rachelefsky G, Schanker H, Patnaik M, Siegel S (1996) Phase I study of anti-IgE recombinant humanized monoclonal antibody rhuMAB-E25 (E25) in adults with moderate to severe asthma. J Allergy Clin Immunol 97:245CrossRefGoogle Scholar
  6. 6.
    Milgrom H, Fick RB Jr, Su JQ, Reimann JD, Bush RK, Watrous ML, Metzger WJ (1999) Treatment of allergic asthma with monoclonal anti-IgE antibody. N Engl J Med 341:1966–73CrossRefPubMedGoogle Scholar
  7. 7.
    Walker S, Monteil M, Phelan K, Lasserson TJ, Walters EH (2006) Anti-IgE for chronic asthma in adults and children (Review). Cochrane Database of Systematic Reviews Issue 2. Art No:CD003559. DOI 10.1002/14651858.CD003559.pub3Google Scholar
  8. 8.
    Busse W, Corren J, Lanier BQ, McAlary M, Fowler-Taylor A, Cioppa GD, van As A, Gupta N (2001) Omalizumab, anti-IgE recombinant humanized monoclonal antibody, for the treatment of severe allergic asthma. J Allergy Clin Immunol 108:184–90CrossRefPubMedGoogle Scholar
  9. 9.
    Solér M, Matz J, Townley R, Buhl R, O'Brien J, Fox H, Thirlwell J, Gupta N, Della Cioppa G (2001) The anti-IgE antibody Omalizumab reduces exacerbations and steroid requirement in allergic asthmatics. Eur Respir J 18:254–61CrossRefPubMedGoogle Scholar
  10. 10.
    Milgrom H, Berger W, Nayak A, Gupta N, Pollard S, McAlary M, Taylor AF, Rohane P (2001) Treatment of childhood asthma with anti-Immunoglobulin E antibody (Omalizumab). Pediatrics 108:36CrossRefGoogle Scholar
  11. 11.
    Humbert M, Beasley R, Ayres J, Slavin R, Hébert J, Bousquet J, Beeh K-M, Ramos S, Canonica GW, Hedgecock S, Fox H, Blogg M, Surrey K (2005) Benefits of Omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment):INNOVATE. Allergy 60:309–16CrossRefPubMedGoogle Scholar
  12. 12.
    Vignola AM, Humbert M, Bousquet J, Boulet L-P, Hedgecock S, Blogg M, Fox H, Surrey K (2004) Efficacy and tolerability of anti-immunoglobulin E therapy with Omalizumab in patients with concomitant allergic asthma and persistent allergic rhinitis:SOLAR. Allergy 59:709–17CrossRefPubMedGoogle Scholar
  13. 13.
    Finn A, Gross G, van Bavel J, Lee T, Windom H, Everhard F, Fowler-Taylor A, Liu J, Gupta N (2003) Omalizumab improves asthma-related quality of life in patients with severe allergic asthma. J Allergy Clin Immunol 111:278–84CrossRefPubMedGoogle Scholar
  14. 14.
    Buhl R, Hanf G, Solèr M, Bensch G, Wolfe J, Everhard F, Champain K, Fox H, Thirlwell J (2002) The anti-IgE antibody Omalizumab improves asthma-related quality of life in patients with allergic asthma. Eur Respir J 20:1088–94CrossRefPubMedGoogle Scholar
  15. 15.
    Holgate ST, Chuchalin AG, Hébert J, Lötvall, Persson GB, Chung KF, Bousquet J, Kerstjens HA, Fox H, Thirlwell J, Della Cioppa G (2004) Efficacy and safety of a recombinant anti-immunoglobulin E antibody (Omalizumab) in severe allergic asthma. Clin Exp Allergy 34:632–8CrossRefPubMedGoogle Scholar
  16. 16.
    Lemanske RF, Nayak A, McAlary M, Everhard F, Fowler-Taylor A, Gupta N (2002) Omalizumab improves asthma-related quality of life in children with allergic asthma. Pediatrics 110:55CrossRefGoogle Scholar
  17. 17.
    Berger W, Gupta N, McAlary M, Fowler-Taylor A (2003) Evaluation of long-term safety of the anti-IgE antibody, Omalizumab, in children with allergic asthma. Ann Allergy Asthma Immunol 91:182–8PubMedCrossRefGoogle Scholar
  18. 18.
    Bousquet J, Wenzel S, Holgate S, Lumry W, Freeman P, Fox H (2004) Predicting response to Omalizumab, an anti-IgE antibody, in patients with allergic asthma. Chest 125:1378–86CrossRefPubMedGoogle Scholar
  19. 19.
    National Asthma Education and Prevention Program Expert Panel Report 3:Guidelines for the Management of Asthma (2007) Draft, National Institutes of Health, National Heart, Lung and Blood InstituteGoogle Scholar
  20. 20.
    Casale TB, Condemi J, LaForce C, Nayak A, Rowe M, Watrous M, McAlary M, Fowler-Taylor A, Racine A, Gupta N, Fick R, Cioppa GD (2001) Effect of Omalizumab on symptoms of seasonal allergic rhinitis. JAMA 286:2956–67CrossRefPubMedGoogle Scholar
  21. 21.
    Adelroth E, Rak S, Haahtela T, Aasand G, Rosenhall L, Zetterstrom O, Byrne A, Champain K, Thirlwell J, Cioppa G, Sandstrõm T (2000) Recombinant humanized mAb-E25, an anti-IgE mAb, in birch pollen-induced seasonal allergic rhinitis. J Allergy Clin Immunol 106:253–9CrossRefPubMedGoogle Scholar
  22. 22.
    Chervinsky P, Casale T, Townley R, Tripathy I, Hedgecock S, Fowler-Taylor A, Shen H, Fox H (2003) Omalizumab, an anti-IgE antibody, in the treatment of adults and adolescents with perennial allergic rhinitis. Ann Allergy Asthma Immunol 91:160–7PubMedGoogle Scholar
  23. 23.
    Bousquet J, van Cauwenberge P, Aït Khaled N, Bachert C, Baena-Cagnani CE, Bouchard J, Bunnag C, Canonica GW, Carlsen KH, Chen YZ, Cruz AA, Custovic A, Demoly P, Dubakiene R, Durham S, Fokkens W, Howarth P, Kemp J, Kowalski ML, Kvedariene V, Lipworth B, Lockey R, Lund V, Mavale-Manuel S, Meltzer EO, Mullol J, Naclerio R, Nekam K, Ohta K, Papadopoulos N, Passalacqua G, Pawankar R, Popov T, Potter P, Price D, Scadding G, Simons FER, Spicak V, Valovirta E, Wang DY, Yawn B, Yusuf O (2006) Pharmacologic and anti-IgE treatment of allergic rhinitis ARIA update. Allergy 61:1086–96CrossRefPubMedGoogle Scholar
  24. 24.
    Thomas M (2006) Allergic rhinitis:evidence for impact on asthma. BMC Pulm Med 6:S4CrossRefPubMedGoogle Scholar
  25. 25.
    MacGlashan Jr DW, Bochner BS, Adelman DC, Jardieu PM, Togias A, McKenzie-White J, Sterbinsky SA, Hamilton RG, Lichtenstein LM (1997) Down-regulation of FcεRI expression on human basophils during in vivo treatment of atopic patients with anti-IgE antibody. J Immunol 158:1438–45PubMedGoogle Scholar
  26. 26.
    Beck LA, Marcotte GV, MacGlashan D, Togias A, Saini S (2004) Omalizumab-induced reductions in mast cell FcεRI expression and function. J Allergy Clin Immunol 114:527–30CrossRefPubMedGoogle Scholar
  27. 27.
    Prussin C, Griffith DT, Boesel KM, Lin H, Foster B, Casale TB (2003) Omalizumab treatment downregulates dendritic cell FcεRI expression. J Allergy Clin Immunol 112:1147–54CrossRefPubMedGoogle Scholar
  28. 28.
    Djukanovic R, Wilson SJ, Kraft M, Jarjour NN, Steel M, Chung KF, Bao W, Fowler-Taylor A, Matthew J, Busse WW, Holgate ST, Fahy JV (2004) Effects of treatment with anti-immu-noglobulin E antibody Omalizumab on airway inflammation in allergic asthma. Am J Respir Crit Care Med 170:583–93CrossRefPubMedGoogle Scholar
  29. 29.
    Noga O, Hanf G, Brachmann I, Klucken AC, Kleine-Tebbe J, Rosseau S, Kunkel G, Suttorp N, Seybold J (2006) Effect of Omalizumab treatment on peripheral eosinophil and T-lymphocyte function in patients with allergic asthma. J Allergy Clin Immunol 117:1493–9CrossRefPubMedGoogle Scholar
  30. 30.
    Casale TB (2001) Anti-immunoglobulin E (Omalizumab) therapy in seasonal allergic rhinitis. Am J Respir Crit Care Med 164:S18–21.PubMedGoogle Scholar
  31. 31.
    Hochhaus G, Brookman L, Fox H, Johnson C, Matthews J, Ren S, Deniz Y (2003) Pharmacodynamics of Omalizumab:implications for optimised dosing strategies and clinical efficacy in the treatment of allergic asthma. Curr Med Res Opin 19:491–8CrossRefPubMedGoogle Scholar
  32. 32.
    Saini SS, MacGlashan DW Jr, Sterbinsky SA, Togias A, Adelman DC, Lichtenstein LM, Bochner BS (1999) Down-regulation of human basophil IgE and Fc epsilon RI alpha surface densities and mediator release by anti-IgE-infusions is reversible in vitro and in vivo. J Immunol 162:5624–30PubMedGoogle Scholar
  33. 33.
  34. 34.
    Deniz YM, Gupta N (2005) Safety and tolerability of Omalizumab (xolair) a recombinant humanized monoclonal anti-IgE antibody. Clin Rev Allergy Immunol 29:31–48CrossRefPubMedGoogle Scholar
  35. 35.
    Xolair (Omalizumab) for subcutaneous use package insert. (June 2003, code revision April 2006) Genentech, Inc and Novartis Pharmaceutical CorporationGoogle Scholar
  36. 36.
    Cruz AA, Lima F, Sarinho E, Ayre G, Martin C, Fox H, Cooper PJ (2007) Safety of anti-immunoglobulin E therapy with Omalizumab in allergic patients at risk of geohelminth infection. Clin Exp Allergy 37:197–207CrossRefPubMedGoogle Scholar
  37. 37.

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Jennifer Preston DeMore
    • 1
  • William W. Busse
    • 1
    • 2
  1. 1.University of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Division of Allergy and Immunology, Department of MedicineUniversity of WisconsinUSA

Personalised recommendations