Gon Yasuhiro, Maruoka Shuichiro, Mizumura Kenji
Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan.
Front Pharmacol. 2022 Mar 10;13:839011. doi: 10.3389/fphar.2022.839011. eCollection 2022.
Omalizumab, a human immunoglobulin (Ig)G1 antibody against IgE, is a therapeutic agent for bronchial asthma. The Global Initiative for Asthma guidelines indicate that the use of omalizumab should be considered as an option in step 5 of treatment for patients with the most severe type of bronchial asthma. In patients with atopic asthma who are at a high risk of exacerbation, and in whom symptoms are poorly controlled despite treatment with inhaled corticosteroids, omalizumab is one of the few drugs that improves symptoms, reduces the risk of exacerbation, and improves the quality of life while offering a high level of safety. On the other hand, the associated treatment costs are high, and there are no clear methods to identify responders. A recent study suggested that evaluating the therapeutic effects and monitoring the pharmacokinetics of omalizumab could improve the success of omalizumab therapy. This review outlines the relationship between IgE-targeted therapy and the serum level of IgE to enhance the current understanding of the mechanism of omalizumab therapy. It also describes the clinical significance of measuring serum free IgE levels and monitoring omalizumab therapy.
奥马珠单抗是一种抗IgE的人免疫球蛋白（Ig）G1抗体，是治疗支气管哮喘的药物。全球哮喘防治创议指南指出，对于最严重类型的支气管哮喘患者，在治疗的第5步应考虑使用奥马珠单抗。在特应性哮喘且有高加重风险、尽管使用吸入性糖皮质激素治疗但症状控制不佳的患者中，奥马珠单抗是少数能改善症状、降低加重风险、提高生活质量且安全性高的药物之一。另一方面，相关治疗费用高昂，且没有明确的方法来识别反应者。最近一项研究表明，评估奥马珠单抗的治疗效果并监测其药代动力学可提高奥马珠单抗治疗的成功率。本综述概述了IgE靶向治疗与IgE血清水平之间的关系，以增进目前对奥马珠单抗治疗机制的理解。它还描述了测量血清游离IgE水平和监测奥马珠单抗治疗的临床意义。
