Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA.
Curr Opin Pulm Med. 2012 Jan;18(1):1-5. doi: 10.1097/MCP.0b013e32834deebb.
IgE plays a pivotal role in allergic asthma especially in the acute response to antigen and in the propagation of airway inflammation. Therefore, it has become apparent that targeting this antibody and blocking its function may lead to significant clinical effects in some patients with the disease. In this review, we describe the role of IgE in asthma and provide an update on the therapeutic implications of targeting this mediator in patients with severe allergic disease. We also outline future needs of research in this area.
Several randomized clinical trials as well as observational real-world studies have confirmed the long-term efficacy of omalizumab in improving clinical outcomes when added to guideline-recommended maintenance of asthma medications (inhaled corticosteroids and long-acting β2-agonists) in patients with moderate-to-severe asthma. Recent pooled data from randomized clinical trials and from a large prospective cohort study provide reassurance about the long-term safety of omalizumab. Future research should explore the long-term effects of omalizumab on the natural history of the disease and identify more accurate predictors of response to this treatment.
The anti-inflammatory effects of omalizumab at different sites of allergic inflammation and its clinical benefits in patients with allergic asthma emphasize the fundamental importance of IgE in allergic inflammation.
IgE 在过敏性哮喘中起着关键作用，特别是在抗原的急性反应中和气道炎症的传播中。因此，很明显，针对这种抗体并阻断其功能可能会导致一些严重过敏疾病患者产生显著的临床效果。在这篇综述中，我们描述了 IgE 在哮喘中的作用，并提供了关于针对这种介质治疗严重过敏疾病患者的治疗意义的最新信息。我们还概述了该领域未来研究的需求。
几项随机临床试验以及观察性真实世界研究证实，奥马珠单抗在添加到指南推荐的维持哮喘药物（吸入皮质类固醇和长效β2-激动剂）治疗中，对中重度哮喘患者的临床结局具有长期疗效。来自随机临床试验和大型前瞻性队列研究的最新汇总数据为奥马珠单抗的长期安全性提供了保证。未来的研究应该探索奥马珠单抗对疾病自然史的长期影响，并确定对这种治疗反应的更准确预测因子。
奥马珠单抗在过敏炎症的不同部位的抗炎作用及其在过敏性哮喘患者中的临床获益强调了 IgE 在过敏炎症中的重要性。
