Review: Omalizumab in the treatment of severe asthma: efficacy and current                 problems

Pelaia, Girolamo; Renda, Teresa; Romeo, Pasquale; Busceti, Maria Teresa; Maselli, Roberta

doi:10.1177/1753465808100431

Cited by 17 publications

(8 citation statements)

References 72 publications

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“…Omalizumab is a humanized monoclonal anti-IgE antibody recently approved for the treatment of allergic asthma, and inhibits allergic responses by binding to serum IgE, thus preventing their interactions with cellular IgE receptors [37]. The reduction of allergen-specific IgE antibody may be related to the efficacy of SST against bronchial asthma.…”

Section: Discussionmentioning

confidence: 99%

Proteomic Analysis of Anti‐inflammatory Effects of a Kampo (Japanese Herbal) Medicine “Shoseiryuto (Xiao‐Qing‐Long‐Tang)” on Airway Inflammation in a Mouse Model

Nagai

Nakao²,

Shimizu³

et al. 2011

Evidence-Based Complementary and Alternative Medicine

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Effects of a Kampo (Japanese herbal) medicine “shoseiryuto (SST, xiao-qing-long-tang in Chinese)”, which has been used for the treatment of allergic bronchial asthma clinically, were examined on ovalbumin (OVA)-sensitized allergic airway inflammation model (i.e., bronchial asthma) in a mouse. When SST was orally administered at 0.5 g kg−1 day−1 from day 1 to 6 after OVA inhalation, SST reduced the inflammation in lung tissue, the number of eosinophils and the OVA-specific immunoglobulin E (IgE) antibody titer in bronchoalveolar lavage (BAL) fluids at 7 days after the OVA inhalation. SST also reduced the airway hyperreactivity at 6 days after the OVA inhalation. Proteomic analysis with the agarose two-dimensional electrophoresis showed that the expression of spectrin α2 was reduced in the lung tissue of OVA-sensitized mice and SST recovered the expression. Western blot and immunohistochemical analyses of lung tissue also confirmed this result. When prednisolone was orally administered at 3 mg kg−1 day−1 from day 1 to 6 after OVA inhalation, the inflammation in lung tissue, the number of eosinophils in BAL fluids and airway hyperreactivity were reduced in the OVA-sensitized mice. However, prednisolone did not reduce the OVA-specific IgE antibody titer in BAL fluids and did not recover the expression of spectrin α2 in lung tissue. These results suggest that at least a part of action mechanism of SST against OVA-sensitized allergic airway inflammation in a mouse model is different from that of prednisolone.

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Section: Discussionmentioning

confidence: 99%

Proteomic Analysis of Anti‐inflammatory Effects of a Kampo (Japanese Herbal) Medicine “Shoseiryuto (Xiao‐Qing‐Long‐Tang)” on Airway Inflammation in a Mouse Model

Nagai

Nakao²,

Shimizu³

et al. 2011

Evidence-Based Complementary and Alternative Medicine

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“…It is surprising that there is only limited potential of the known biologicals developed specifically for allergy [34]. Anti‐IgE has major IgE decreasing effects, but is only indicated in a small subset of allergic asthmatics [35] at present although licensing studies for chronic urticaria are in an advanced stage. Blocking eosinophil differentiation and activation by anti‐IL‐5 is effective in vitro, but results from clinical studies [36], suggest the need for identifying responsive populations.…”

Section: Understanding the Allergy Epidemicmentioning

confidence: 99%

Research needs in allergy: an EAACI position paper, in collaboration with EFA

Papadopoulos¹,

Agache

Bavbek

et al. 2012

Clinical & Translational All

147

103

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In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients’ organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels.Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders...

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“… 13 , 19 The main clinical and functional outcomes of the pharmacological mechanism of action of omalizumab include a significant decrease in the number and severity of asthma exacerbations, better symptom control, and an improvement of airflow limitation. 13 , 19 The add-on treatment of severe allergic asthma with omalizumab thus represents an excellent example of precision medicine consisting of a biological therapy directed against a molecular target, namely IgE, which is overexpressed in atopic patients and plays a prominent role in disease pathophysiology. Therefore, the use of omalizumab in asthma treatment makes it possible to realize a targeted therapy addressed towards a specific phenotype, such as allergic asthma, driven by an IgE-mediated underlying endotype.…”

Section: Introductionmentioning

confidence: 99%

Omalizumab, the first available antibody for biological treatment of severe asthma: more than a decade of real-life effectiveness

Pelaia

Calabrese

Terracciano

et al. 2018

Ther Adv Respir Dis

Self Cite

110

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Omalizumab was the first, and for a long time the only available monoclonal antibody for the add-on treatment of severe allergic asthma. In particular, omalizumab selectively targets human immunoglobulin (Ig)E, forming small-size immune complexes that inhibit IgE binding to its high- and low-affinity receptors. Therefore, omalizumab effectively blunts the immune response in atopic asthmatic patients, thus significantly improving the control of asthma symptoms and successfully preventing disease exacerbations. These very positive effects of omalizumab make it possible to drastically decrease both referrals to the emergency room and hospitalizations for asthma exacerbations. Such important therapeutic actions of omalizumab have been documented by several randomized clinical trials, and especially by more than 10 years of real-life experience in daily clinical practice. Omalizumab can also interfere with airway remodelling by inhibiting the activation of IgE receptors located on structural cells such as bronchial epithelial cells and airway smooth muscle cells. Moreover, omalizumab is characterized by a very good safety and tolerability profile. Hence, omalizumab represents a valuable therapeutic option for the add-on biological treatment of severe allergic asthma.

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Review: Omalizumab in the treatment of severe asthma: efficacy and current problems

Cited by 17 publications

References 72 publications

Proteomic Analysis of Anti‐inflammatory Effects of a Kampo (Japanese Herbal) Medicine “Shoseiryuto (Xiao‐Qing‐Long‐Tang)” on Airway Inflammation in a Mouse Model

Proteomic Analysis of Anti‐inflammatory Effects of a Kampo (Japanese Herbal) Medicine “Shoseiryuto (Xiao‐Qing‐Long‐Tang)” on Airway Inflammation in a Mouse Model

Research needs in allergy: an EAACI position paper, in collaboration with EFA

Omalizumab, the first available antibody for biological treatment of severe asthma: more than a decade of real-life effectiveness

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