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变应性哮喘中 IgE 介导的多种共病及奥马珠单抗治疗的潜力。

IgE-Mediated Multimorbidities in Allergic Asthma and the Potential for Omalizumab Therapy.

机构信息

Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France.

MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.

出版信息

J Allergy Clin Immunol Pract. 2019 May-Jun;7(5):1418-1429. doi: 10.1016/j.jaip.2019.02.030. Epub 2019 Mar 27.

Abstract

Allergic asthma often coexists with different pathological conditions, called multimorbidities, that are mostly of allergic nature and share a common underlying inflammatory pathophysiological mechanism. Multimorbidities of allergic asthma may influence asthma control, its severity, and patients' response to treatment, and contribute to the overall socioeconomic burden of the disease. Immunoglobulin E (IgE) is known to play a central role in the pathogenesis of various allergic diseases, including asthma. Thus, IgE-mediated immunologic pathways present an attractive target for intervention in asthma and multimorbidities. In this review, we discuss the most frequently reported IgE-mediated multimorbidities in allergic asthma, including allergic rhinitis, rhinoconjunctivitis, atopic dermatitis, vernal keratoconjunctivitis, chronic rhinosinusitis with nasal polyps, food allergies, and allergic bronchopulmonary aspergillosis. Omalizumab is a recombinant humanized monoclonal antibody against IgE and has been in use to treat allergic asthma for more than a decade. We comprehensively review the clinical evidence for omalizumab in the treatment of the aforementioned multimorbidities in allergic asthma.

摘要

过敏性哮喘常伴有多种不同的病理状况,称为共病,这些共病大多具有过敏性,并具有共同的潜在炎症病理生理机制。过敏性哮喘的共病可能会影响哮喘控制、严重程度以及患者对治疗的反应,并导致疾病的总体社会经济负担。免疫球蛋白 E(IgE)已知在包括哮喘在内的各种过敏性疾病的发病机制中起核心作用。因此,IgE 介导的免疫途径是哮喘和共病干预的一个有吸引力的靶点。在这篇综述中,我们讨论了过敏性哮喘中最常报道的 IgE 介导的共病,包括过敏性鼻炎、鼻结膜炎、特应性皮炎、春季角结膜炎、伴有鼻息肉的慢性鼻-鼻窦炎、食物过敏和过敏性支气管曲霉病。奥马珠单抗是一种针对 IgE 的重组人源化单克隆抗体,已用于治疗过敏性哮喘超过十年。我们全面审查了奥马珠单抗在治疗上述过敏性哮喘共病中的临床证据。

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