Anti-immunoglobulin E therapy for asthma

The role of immunoglobulin E (IgE) in allergic asthmatic disease is well established. Allergen-specific IgE binds to its cognate receptors, thus triggering a series of cellular events. These events include presentation of antigen by dendritic cells and the degranulation of mast cells and basophils to release numerous factors that play an integral part in potentiating the disease symptoms. Studies in the mouse indicate that a reduction in IgE levels could lead to significant attenuation of the allergic inflammatory response associated with diseases such as asthma, making IgE a target for the development of new therapeutic agents. Omalizumab (Xolair, a recombinant humanized monoclonal anti-IgE antibody that blocks the interaction of IgE with its receptors, is the first anti-IgE agent to undergo clinical development. Several clinical studies have been performed in adults and children with moderate-to-severe allergic asthma to evaluate the efficacy and safety of this agent. Treatment with omalizumab was well tolerated and showed clinical benefit in terms of a reduction in the frequency and number of asthma exacerbation episodes and lower usage of corticosteroids and other medications to control disease, along with improved quality of life. Such findings indicate that omalizumab represents a promising new treatment option for allergic asthma.