Department of Infection, Inflammation & Repair, University of Southampton, Mailpoint 810 South Academic Block, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
Expert Rev Respir Med. 2009 Jun;3(3):299-308. doi: 10.1586/ers.09.11.
Allergic diseases are mediated by IgE and, hence, neutralizing IgE to attenuate type I hypersensitivity reactions may result in clinical benefits. This has been mainly established in several large pre- and postmarketing studies of the humanized monoclonal anti-IgE antibody, omalizumab, in patients with allergic asthma. In this patient population, omalizumab has been shown to have beneficial effects in subjective and objective outcome measures, as well as resulting in reductions in medication use. Omalizumab is now globally licensed for use in severe persistent asthma. However, a growing number of reports suggest that anti-IgE treatment may also be beneficial to patients suffering from other IgE-related conditions, including allergic rhinitis, peanut allergy, latex sensitivity, atopic dermatitis, chronic urticaria and allergic bronchopulmonary aspergillosis. For these patients, and specifically for those with severe refractory disease, anti-IgE treatments might have the potential of reducing their financial burden both in terms of medical costs and of loss of productivity in missed work and school days. In this reveiw, we evaluate the evidence in support of a more extensive role for omalizumab in a number of non-asthma IgE-related conditions, and particularly where intensive treatment has not been effective. However, studies with larger numbers of well-characterized patients will be necessary to provide sound evidence regarding the benefit of IgE blockade in these challenging conditions.
过敏疾病由 IgE 介导，因此，中和 IgE 以减轻 I 型超敏反应可能会带来临床获益。这主要是在几项大型的奥马珠单抗（一种人源化单克隆抗 IgE 抗体）上市前和上市后研究中确立的，奥马珠单抗用于治疗过敏性哮喘患者。在这一患者群体中，奥马珠单抗在主观和客观的结局指标中均显示出有益的效果，并且减少了药物的使用。奥马珠单抗现已在全球范围内被批准用于严重持续性哮喘的治疗。然而，越来越多的报告表明，抗 IgE 治疗可能对患有其他 IgE 相关疾病的患者也有益，包括过敏性鼻炎、花生过敏、乳胶过敏、特应性皮炎、慢性荨麻疹和变应性支气管肺曲霉病。对于这些患者，特别是那些患有严重难治性疾病的患者，抗 IgE 治疗可能有潜力减轻他们在医疗费用和因错过工作和上学日而导致的生产力损失方面的经济负担。在这篇综述中，我们评估了奥马珠单抗在一些非哮喘 IgE 相关疾病中发挥更广泛作用的证据，特别是在强化治疗无效的情况下。然而，需要进行更多具有大量特征明确患者的研究，以提供关于 IgE 阻断在这些具有挑战性的疾病中获益的可靠证据。
