Omalizumab's Impact on Total and Allergen-Specific IgE Levels: A Polyclonal Story

Eckl‐Dorna, Julia

doi:10.1159/000444998

Cited by 12 publications

(13 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Total IgE baseline levels are frequently slightly elevated in patients with CSU, especially in those who respond promptly to omalizumab (7)(8)(9). Omalizumab administration eventually leads to an increase in total IgE levels while reducing their free fraction due to the prolongation of their half-life, and such increase may last for more than one year after stopping the treatment (12). Since fast omalizumab responders represented the whole population enrolled in the study it is not surprising that total IgE levels were frequently elevated before omalizumab treatment and increased in all cases under anti-IgE therapy.…”

Section: Discussionmentioning

confidence: 99%

Are currently available biomarkers useful to discriminate CSU patients not controlled by low dose omalizumab maintenance therapy?

Asero

2020

Eur Ann Allergy Clin Immunol

View full text Add to dashboard Cite

In patients with chronic spontaneous urticaria (CSU), low dose omalizumab maintenance therapy is effective in about one half of complete, fast responders to the drug. Omalizumab 150 mg/month was given as maintenance therapy to 21 patients with a history of severe CSU showing a complete (UAS7= 0) response to the dose of 300 mg/month. After 2 months of such regimen, patients were divided into controlled (n= 14; UAS7= 0) and not controlled (n= 7; UAS7 > 10) and ESR, CRP, total IgE, and D-dimer were measured. The two groups did not differ in any of the biomarkers considered, nor in disease duration or in pre-treatment UAS7 score. The study confirms that it is possible to halve the dose of Omalizumab without any loss of efficacy in a subgroup of patients with CSU but that none of the currently available biomarkers is able to predict which patients will lose disease control following omalizumab dose reduction.

show abstract

Section: Discussionmentioning

confidence: 99%

Are currently available biomarkers useful to discriminate CSU patients not controlled by low dose omalizumab maintenance therapy?

Asero

2020

Eur Ann Allergy Clin Immunol

View full text Add to dashboard Cite

show abstract

“…Only in 3 patients, IgE sensitization to cat and mite allergens exceeding cut‐off IgE levels was noted. This observation is in line with a recent study conducted by Mizuma et al., where the authors described patients while exhibiting Japanese cedar‐specific IgE levels above 0.35 kU/L only after omalizumab therapy had already suffered from cedar pollinosis before therapy 13, 14. Using an assay able to distinguish IgE‐omalizumab complexes from IgE and omalizumab alone, we could demonstrate the formation of IgE‐omalizumab complexes after subcutaneous omalizumab administration, which correlated to some extent with the increase in total IgE.…”

Section: Discussionmentioning

confidence: 77%

“…The first possibility is based on findings that the administration of anti‐IgE antibodies into primed mice16 as well as injection of oligomeric allergen derivatives17 which are able to cross‐link the BCR on IgE‐producing memory cells into sensitized mice can boost secondary IgE production. This hypothesis has been controversially discussed with arguments in favour14, 16, 32, 33 and against34, 35 the potential of omalizumab to activate IgE + memory B cells. In the present study, both in our in vivo intranasal challenge model and in our in vitro approach using a well‐established system to induce IgE production,30, 31 we did not observe any enhancing effect of omalizumab on IgE production.…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore possible that cross‐linking of the BCR on IgE + memory cells may contribute to the strong increases in IgE levels which are observed in patients treated with omalizumab in addition to a prolongation of the half‐life of IgE within the omalizumab‐IgE immune complexes 5, 13, 14. In this context, it has recently been hypothesized that the binding of omalizumab to IgE may prevent degradation of IgE via binding of the resulting IgE‐IgG complex to the neonatal Fc receptor (FcRn) and thus protecting it from endolysosomal degradation or that the IgE‐omalizumab complexes do not undergo pinocytosis 15.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intranasal administration of allergen increases specific IgE whereas intranasal omalizumab does not increase serum IgE levels—A pilot study

Eckl‐Dorna

Fröschl

Lupinek

et al. 2017

Allergy

View full text Add to dashboard Cite

BackgroundAdministration of the therapeutic anti‐IgE antibody omalizumab to patients induces strong increases in IgE antibody levels.ObjectiveTo investigate the effect of intranasal administration of major birch pollen allergen Bet v 1, omalizumab or placebo on the levels of total and allergen‐specific IgE in patients with birch pollen allergy.MethodsBased on the fact that intranasal allergen application induces rises of systemic allergen‐specific IgE, we performed a double‐blind placebo‐controlled pilot trial in which birch pollen allergic subjects were challenged intranasally with omalizumab, placebo or birch pollen allergen Bet v 1. Total and allergen‐specific IgE, IgG and basophil sensitivity were measured before and 8 weeks after challenge. For control purposes, total, allergen‐specific IgE levels and omalizumab‐IgE complexes as well as specific IgG levels were studied in subjects treated subcutaneously with either omalizumab or placebo. Effects of omalizumab on IgE production by IL‐4/anti‐CD40‐treated PBMCs from allergic patients were studied in vitro.ResultsIntranasal challenge with Bet v 1 induced increases in Bet v 1‐specific IgE levels by a median of 59.2%, and this change differed significantly from the other treatment groups (P = .016). No relevant change in allergen‐specific and total IgE levels was observed in subjects challenged with omalizumab. Addition of omalizumab did not enhance IL‐4/anti‐CD40‐induced IgE production in vitro. Significant rises in total IgE (mean IgE before: 131.83 kU/L to mean IgE after: 505.23 kU/L) and the presence of IgE‐omalizumab complexes were observed after subcutaneous administration of omalizumab.ConclusionIntranasal administration of allergen induced rises of allergen‐specific IgE levels, whereas intranasal administration of omalizumab did not enhance systemic total or allergen‐specific IgE levels.

show abstract

“…Thereby, FcεRI on the surface of basophils and mast cells undergo downregulation. Omalizumab increases total IgE levels, while decreasing free IgE levels by more than 95% [ 3 ]. The increase in total IgE levels can generally be explained by the prolongation of the half-life of IgE, which has a half-life of 2–3 days, by binding to omalizumab of IgG1 structure, which has a half-life of 26 days [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of omalizumab treatment on IgE and other immunoglobulin levels in patients with chronic spontaneous urticaria and its association with treatment response

Çildağ¹,

Şentürk²

2018

pdia

View full text Add to dashboard Cite

IntroductionSuppression of free immunoglobulin E (IgE) levels and an increase in total IgE levels are observed during omalizumab treatment. However, whether omalizumab has any effect on other immunoglobulins is unknown.AimTo investigate the effect of omalizumab treatment on serum IgE and other immunoglobulins, and demonstrate any association with response to treatment in patients with chronic spontaneous urticaria (CSU).Material and methodsThe study included 41 patients diagnosed with CSU. Baseline and post-12-week-treatment total IgE, IgA, IgM, and IgG levels and blood eosinophil, neutrophil, lymphocyte and platelet levels were compared. Patients were grouped based on weekly urticaria activity score (UAS-7) responses and these parameters were compared.ResultsThere was a significant increase in baseline and post-12-week-treatment total IgE levels, while there was no significant difference in other immunoglobulin levels. A significant reduction was found in neutrophil counts after the treatment, whereas there was no significant difference in eosinophil, lymphocyte and platelet levels. There was no difference in these parameters between groups with complete response and without complete response.ConclusionsOmalizumab treatment can also be used in patients with immunoglobulin deficiency. Due to the observed reduction in neutrophil counts after the treatment, patients must be closely followed for whole blood parameters.

show abstract

Omalizumab's Impact on Total and Allergen-Specific IgE Levels: A Polyclonal Story

Cited by 12 publications

References 5 publications

Are currently available biomarkers useful to discriminate CSU patients not controlled by low dose omalizumab maintenance therapy?

Are currently available biomarkers useful to discriminate CSU patients not controlled by low dose omalizumab maintenance therapy?

Intranasal administration of allergen increases specific IgE whereas intranasal omalizumab does not increase serum IgE levels—A pilot study

The effect of omalizumab treatment on IgE and other immunoglobulin levels in patients with chronic spontaneous urticaria and its association with treatment response

Contact Info

Product

Resources

About