Targeted IgE Therapy for Patients With Moderate to Severe Asthma

It is well established that the proinflammatory cytokine immunoglobulin E (IgE) is a primary contributor to development of allergic airway inflammation following allergen exposure. Recent data suggest that blocking the effects of IgE with omalizumab, a recombinant DNA-derived humanized monoclonal antibody that inhibits the binding of IgE, is an effective strategy for the treatment of asthma, particularly for moderate to severe asthma that is difficult to control with inhaled corticosteroids and traditional controller medications. Targeting specific steps in the inflammatory cascade with omalizumab improves daytime and nocturnal symptom control, reduces exacerbations, and decreases the need for inhaled corticosteroids and beta(2) agonists. These benefits, along with improved daily functioning, have resulted in a clinically meaningful improvement in asthma-related quality of life for a substantial number of patients. This paper briefly reviews the contribution of IgE to the development of airway inflammation, discusses the clinical benefits of IgE-blocker therapy, and profiles the patient who stands to benefit from this new and innovative form of therapy.