Among the different types of bronchial asthma, the allergic one is certainly the most easily found. Allergic asthma is characterized by the presence of IgE antibodies called "reagine", responsible for triggering respiratory allergic crises in the presence of perennial or seasonal specifi c allergens.Allergic asthma with severe and persistent symptoms, with high levels of circulating IgE, can be treated with Omalizumab, a humanized monoclonal antibody obtained from recombinant DNA.It selectively bounds to human IgE and reduces the release of histamine and leukotrienes responsible for allergic symptoms.Unlike traditional anti-IgE drugs, Mepolizumab does not interact with IgE-pathway but interacts with the IL-5 pathway.Interleukin 5 (IL-5) represents the causal agent triggering growth, activation and survival of eosinophil cells and provides an essential signal for the migration of eosinophils from the bone marrow to the lungs. Some studies suggest that almost 60% of patients with severe asthma present an eosinophilic infl ammation of the respiratory tract. Mepolizumab is a monoclonal antibody IgG1 kappa, not glycosylated, that binds to IL-5, preventing its binding to IL-5 receptor on the surface of eosinophils.The blockade of IL-5 causes a reduction in the production and activation of eosinophils and is an innovative modality for the treatment of eosinophilic asthma.In this article, we report our experience in the treatment of patients with severe, uncontrolled eosinophilic asthma using Mepolizumab: some of the examined patients had previously been treated with omalizumab with poor symptom control.
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