Humbert M, Tonnel A B
Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine-Béclère, Université Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France.
Rev Mal Respir. 2005 Dec;22(6 Pt 1):983-90. doi: 10.1019/200530175.
Immunoglobulin E (IgE) is a key factor of allergic reaction and is known to be involved in the immunopathology of asthma. In this review, we discuss the results of trials of a monoclonal antibody (omalizumab) against IgE in patients with allergic asthma.
Omalizumab is a humanised murine IgG1 kappa monoclonal antibody which is administered subcutaneously every 2 to 4weeks at a dose calculated according to the patient's body weight and total plasma IgE concentrations. It binds free circulating IgE thus preventing it from binding to high affinity receptors. Omalizumab therapy significantly reduces asthma exacerbations, improves quality of life and has a steroid-sparing effect. It has a good safety profile. This treatment appears to be more effective in the patients with the most severe disease and the worst lung function.
Omalizumab therapy is an important novel treatment for difficult-to-control allergic asthma. Because of its systemic mechanism of action, it may be of particular use in patients displaying multiple allergic pathologies. It remains unknown whether the beneficial effects of omalizumab could be extended to patients with severe non allergic (so-called "intrinsic") asthma, a variant of the disease which is often difficult to control.
免疫球蛋白E（IgE）是过敏反应的关键因素，已知其参与哮喘的免疫病理学过程。在本综述中，我们讨论了针对过敏性哮喘患者的抗IgE单克隆抗体（奥马珠单抗）的试验结果。
奥马珠单抗是一种人源化鼠IgG1κ单克隆抗体，每2至4周皮下注射一次，剂量根据患者体重和血浆总IgE浓度计算。它与游离的循环IgE结合，从而阻止其与高亲和力受体结合。奥马珠单抗治疗可显著减少哮喘发作，改善生活质量，并具有节省类固醇的作用。它具有良好的安全性。这种治疗方法在病情最严重、肺功能最差的患者中似乎更有效。
奥马珠单抗治疗是难治性过敏性哮喘的一种重要的新型治疗方法。由于其全身性作用机制，它可能对表现出多种过敏病理的患者特别有用。奥马珠单抗的有益效果是否能扩展到重度非过敏性（所谓“特发性”）哮喘患者，这一疾病变体往往难以控制，目前尚不清楚。
