Yu Lin, Zhang Huishan, Pan Jianwei, Ye Leping
Department of Pediatrics, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
Department of Pediatrics, Peking University First Hospital, Beijing, China.
World Allergy Organ J. 2021 Dec 11;14(12):100614. doi: 10.1016/j.waojou.2021.100614. eCollection 2021 Dec.
Allergic and related diseases have a substantial epidemiological impact on the pediatric population. Small molecule-based medicines have been traditionally used to manage the diseases. Omalizumab is the first monoclonal antibody-based medicine used in children's allergy and shows great promises. It binds to free IgE and prevents it from binding to IgE receptors, thus interrupting the IgE-dependent allergic inflammatory cascade. Vast amounts of data demonstrate its effectiveness and well tolerance by patients, including the children. However, the drug was only approved to use in allergic asthma and chronic spontaneous urticaria (CSU), though other applications were explored in clinical trials. In this review, we summarized current pediatric applications of omalizumab in allergic diseases, focusing on its usages beyond asthma and CSU, including allergic rhinitis, allergic bronchopulmonary aspergillosis, vernal keratoconjunctivitis, food allergy and atopic dermatitis. In addition, we highlighted the unmet needs and controversial issues of anti-IgE therapy.
过敏性及相关疾病对儿童群体具有重大的流行病学影响。传统上一直使用基于小分子的药物来治疗这些疾病。奥马珠单抗是首个用于儿童过敏治疗的单克隆抗体药物,前景广阔。它与游离的免疫球蛋白E(IgE)结合,阻止其与IgE受体结合,从而中断IgE依赖的过敏性炎症级联反应。大量数据证明了其有效性以及包括儿童在内的患者对其良好的耐受性。然而,该药物仅被批准用于过敏性哮喘和慢性自发性荨麻疹(CSU),尽管在临床试验中探索了其他应用。在本综述中,我们总结了奥马珠单抗目前在儿童过敏性疾病中的应用,重点关注其在哮喘和CSU之外的用途,包括过敏性鼻炎、变应性支气管肺曲霉病、春季角结膜炎、食物过敏和特应性皮炎。此外,我们强调了抗IgE治疗尚未满足的需求和存在争议的问题。