Allergy and Respiratory Diseases, DIMI, University of Genoa, Italy.
Int J Immunopathol Pharmacol. 2012 Apr-Jun;25(2):475-84. doi: 10.1177/039463201202500217.
Severe persistent asthma causes a substantial morbidity and mortality burden and is frequently not well controlled, despite intensive guideline-based therapy. The unique monoclonal antibody approved for patients with severe allergic asthma is omalizumab: a recombinant humanised murine against IgE antibodies. The aim of the present study is to investigate the effect of long-term anti-IgE on the thickening of the reticular basement membrane (RBM) and eosinophil infiltration in bronchial biopsies from patients with severe persistent allergic asthma. Biopsies were obtained from 11 patients with severe persistent allergic asthma before and after (12 months) treatment with omalizumab. RBM thickness and eosinophils were measured by using light microscope image analysis. A significant mean reduction in RBM thickness and eosinophil infiltration were measured after one-year omalizumab treatment. No correlation between eosinophil reduction and RBM thickness reduction was found. No correlation between each of the previous two parameters and clinical parameters was detected. In conclusion, our study showed that a substantial proportion of severe asthmatics reduced the original bronchial RBM thickness and eosinophil infiltration after one-year treatment with anti-IgE, thus emphasizing the possible role of omalizumab in affecting airway remodeling in severe persistent allergic asthma.
严重持续性哮喘会导致大量的发病率和死亡率，并且尽管进行了基于指南的强化治疗，但常常无法得到很好的控制。唯一批准用于严重过敏性哮喘患者的特异性单克隆抗体是奥马珠单抗：一种针对 IgE 抗体的重组人源化鼠单克隆抗体。本研究旨在探讨长期抗 IgE 对严重持续性过敏性哮喘患者支气管活检中网状基底膜（RBM）增厚和嗜酸性粒细胞浸润的影响。从 11 例严重持续性过敏性哮喘患者中获取支气管活检标本，在接受奥马珠单抗治疗前后（12 个月）进行测量。通过光学显微镜图像分析测量 RBM 厚度和嗜酸性粒细胞浸润。奥马珠单抗治疗一年后，RBM 厚度和嗜酸性粒细胞浸润均显著降低。嗜酸性粒细胞减少与 RBM 厚度减少之间没有相关性。也没有检测到以前的两个参数中的任何一个与临床参数之间的相关性。总之，我们的研究表明，在接受抗 IgE 治疗一年后，相当一部分严重哮喘患者的原始支气管 RBM 厚度和嗜酸性粒细胞浸润减少，这强调了奥马珠单抗可能在影响严重持续性过敏性哮喘的气道重塑方面发挥作用。
