Wollenberg Andreas, Thomsen Simon Francis, Lacour Jean-Philippe, Jaumont Xavier, Lazarewicz Slawomir
Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany.
Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
World Allergy Organ J. 2021 Mar 19;14(3):100519. doi: 10.1016/j.waojou.2021.100519. eCollection 2021 Mar.
Immunoglobulin E (IgE) plays an essential role in many allergic diseases. This review highlights the role of IgE in atopic dermatitis (AD), a common, chronic, and complex skin inflammation, and the available therapeutic approaches that target IgE in AD. We examine the existing data showing the use of omalizumab, the only biologic anti-IgE therapy available in clinical use, plasma apheresis, and a combination of both therapeutic approaches for the treatment of AD. Existing data on the efficacy of omalizumab in AD are inconclusive. A limited number of randomised controlled studies, few uncontrolled prospective and retrospective reports, as well as multiple case series and case reports observed varying degrees of the efficacy of omalizumab in AD. Omalizumab displays a trend of higher efficacy in AD patients with low IgE levels compared with those with very high-to-extremely high serum IgE concentrations. Plasma apheresis and its combination with omalizumab show good efficacy, even in patients with unusually high serum IgE concentrations. Combining apheresis and anti-IgE treatment may serve as a comprehensive therapeutic approach for patients with elevated levels of IgE. Dedicated clinical studies with robust study designs are needed to establish the therapeutic efficacy of omalizumab in AD.
免疫球蛋白E（IgE）在许多过敏性疾病中发挥着重要作用。本综述重点介绍了IgE在特应性皮炎（AD）中的作用，AD是一种常见、慢性且复杂的皮肤炎症，以及针对AD中IgE的现有治疗方法。我们研究了现有数据，这些数据显示了奥马珠单抗（临床使用的唯一一种生物抗IgE疗法）、血浆置换以及这两种治疗方法联合用于治疗AD的情况。关于奥马珠单抗在AD中疗效的现有数据尚无定论。有限数量的随机对照研究、为数不多的非对照前瞻性和回顾性报告以及多个病例系列和病例报告观察到奥马珠单抗在AD中的疗效程度各不相同。与血清IgE浓度非常高至极高的AD患者相比，奥马珠单抗在IgE水平低的AD患者中显示出更高疗效的趋势。血浆置换及其与奥马珠单抗联合使用显示出良好疗效，即使在血清IgE浓度异常高的患者中也是如此。将血浆置换与抗IgE治疗相结合可能是IgE水平升高患者的一种综合治疗方法。需要进行设计严谨的专门临床研究来确定奥马珠单抗在AD中的治疗效果。
