[Pathophysiological and pharmacotherapeutic aspects of IgE-mediated allergic reactions]

IgE-mediated allergic diseases are associated with a predominant T-helper (Th) 2 activation. Th2 cytokines regulate IgE production as well as production, tissue infiltration and survival of eosinophils. Advances in our understanding of the pathogenesis of allergic diseases have led to new treatment guidelines, especially for bronchial asthma. Current therapies either neutralize a specific mediator (antihistamines, antileukotrienes) or suppress the immune system in an unspecific manner (corticosteroids). New strategies involve both early intervention within the pathogenic mechanism and high specificity by targeting key molecules. It is hoped that it might be possible to develop drugs with higher efficacy and less side effects. There is a particular need for developing drugs for allergic patients who either require high doses of or do not respond to corticosteroids. This review focuses on mechanisms of IgE-mediated allergic diseases and describes where current and new potential drugs interfere within these pathogenic processes.