From IgE to clinical trials of allergic rhinitis

Abstract

The current scientific research is continuously aiming at identifying new therapeutic targets with the purpose of modifying the immune response to allergens. The evolution in immunological methods has led to the identification of immunoglobulin E (IgE) as both a diagnostic biomarker and potential therapeutic target in allergic diseases, such as allergic rhinitis. Allergen immunotherapy has been used for more than 100 years to treat allergic diseases and it is today considered the only disease-modifying treatment capable of inducing a long-lasting immunological and clinical tolerance toward the causal allergen. During the past 20 years, major advances have been made in understanding the molecular and cellular mechanisms of allergen tolerance in humans. Moreover, there has been considerable progress in allergen extract modifications and additions to standard extracts. The recognition that IgE plays a pivotal role in basic regulatory mechanisms of allergic inflammation has recently stimulated research into the therapeutic potential of directly targeting this antibody. Omalizumab, the most advanced humanized anti-IgE monoclonal antibody, is currently approved for the treatment of uncontrolled allergic asthma and chronic spontaneous urticaria. Interesting results also arise from studies in which omalizumab was administered in patients with allergic rhinitis. The aim of this review is to provide an update on current findings on immunological and clinical effects of allergen immunotherapy and anti-IgE therapy, which have been shown to have synergistic modes of action for the treatment of allergic rhinitis.

Anti-Interleukin-9 Antibody Increases the Effect of Allergen-Specific Immunotherapy in Murine Allergic Rhinitis

“…Many patients with AR have insufficient relief of symptoms and seek anti-allergic medications as the first treatment 123. Allergen immunotherapy is an effective and fundamental treatment for allergic diseases, such as asthma and AR.…”

Pilot Project «All-Russian Registry of Patients with Severe Bronchial Asthma.» The First Results in a Children’s Group of Patients (Moscow’s Observation Program)

“…Полученные данные о частоте коморбидных аллерги-ческих заболеваний и наследственной предрасположен-ности к развитию заболевания у пациентов с БА отражают общемировую тенденцию [3][4][5][6]. Аллергический ринит -достаточно распространенное заболевание, поражает до 30% общей популяции [5].…”

“…Аллергический ринит -достаточно распространенное заболевание, поражает до 30% общей популяции [5]. При этом неуклонно растет количество пациентов как среди детей, так и у взрослых.…”

Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management

“…Moreover, several systematic reviews supported the specific use of SLIT in the treatment of AR in children, as well as the EAACI position paper on pediatric rhinitis did. Recent analyses inferred a moderate strength and general evidence that SLIT improves pediatric AR and conjunctivitis, ameliorating symptoms and/or decreasing the drug consumption[12,91-93]. This evidence resulted to be stronger for grass pollen SLIT in the treatment of isolated AR, whereas the evidence for house dust mite SLIT effectiveness is still considered “of moderate-low quality”, as resulted from few available randomized controlled trials.…”