Targeting immunoglobulin E in atopic dermatitis: A review of the existing evidence

Abstract

Immunoglobulin E (IgE) plays an essential role in many allergic diseases. This review highlights the role of IgE in atopic dermatitis (AD), a common, chronic, and complex skin inflammation, and the available therapeutic approaches that target IgE in AD. We examine the existing data showing the use of omalizumab, the only biologic anti-IgE therapy available in clinical use, plasma apheresis, and a combination of both therapeutic approaches for the treatment of AD. Existing data on the efficacy of omalizumab in AD are inconclusive. A limited number of randomised controlled studies, few uncontrolled prospective and retrospective reports, as well as multiple case series and case reports observed varying degrees of the efficacy of omalizumab in AD. Omalizumab displays a trend of higher efficacy in AD patients with low IgE levels compared with those with very high-to-extremely high serum IgE concentrations. Plasma apheresis and its combination with omalizumab show good efficacy, even in patients with unusually high serum IgE concentrations. Combining apheresis and anti-IgE treatment may serve as a comprehensive therapeutic approach for patients with elevated levels of IgE. Dedicated clinical studies with robust study designs are needed to establish the therapeutic efficacy of omalizumab in AD.

Investigation on the Correlation between Serum Immune Factor Levels and Allergic Constitution in Children with Infectious Mononucleosis

“…At present, there are few research studies on the mechanism of allergic constitution, so that the mechanism is still unclear. However, Caca and Cooke proposed in 1923 the “atopic constitution” that is prone to hypersensitivity reactions due to high IgE levels [ 9 , 10 ]; it is very similar to the allergic constitution proposed by Chinese medicine; and Wollenberg, Thomsen, and Lazarewicz believed that the specific IgE in people with allergies is relatively high [ 11 ]. Based on the above theories, it can be inferred that IgE is closely related to allergies.…”

Insights into the Implications of Coexisting Type 2 Inflammatory Diseases

“…Studies investigating the utility of omalizumab in AD have been inconclusive. 55 Additionally, dupilumab, which targets the shared receptor subunit for IL-4 and IL-13, has shown good results in the treatment of asthma, AD, and CRS. 56 A recent Phase 2 clinical trial has also shown promise in the management of EOE, 14 results that other biologic agents have failed to produce up to this point.…”

Characterization and In Vitro and In Vivo Evaluation of Tacrolimus-Loaded Poly(ε-Caprolactone) Nanocapsules for the Management of Atopic Dermatitis

“…G4 (n = 10) Animals treated with TPA and TAC at a concentration of 0.1% (w/v) (0.4 mL/animal 1 ) (TAC Group) G5 (n = 10) Animals treated with TPA and TAC-loaded PCL nanocapsules at a drug concentration of 0.1% (w/v) (0.44 mL/animal 1,2,3 ) (NC-1 Group) 1 These volumes were firstly based on the mean weight of each mice group. 2 The drug encapsulation efficiency was also considered for TAC-loaded PCL nanocapsule suspensions. 3 The same volume was used for TAC-loaded and non-loaded PCL nanocapsules (NC-1 and NC-N).…”

“…Atopic dermatitis (AD), or eczema, is a dermatological, inflammatory, non-infectious, and chronic disease characterized by long-lasting itching of the affected skin and involves a combination of genetic factors that affect the skin barrier and the immune system [1]. The disease affects about 25% of children and 1 to 3% of adults worldwide [2][3][4]. The common symptoms include skin rashes, erythema, papules, localized exudative lesions, and dry skin.…”

“…According to Wollenberg et al (2021) [2], several treatments for AD and patients with transient levels are available. The most common remedies include avoiding the triggers that induce the disease, using emollients that improve epidermal function, nonspecific anti-inflammatory drugs, and therapies with immunosuppressants such as class II glucocorticoids and calcineurin inhibitors.…”