The size of the disease relevant IgE antibody fraction in relation to ‘total‐IgE’ predicts the efficacy of anti‐IgE (Xolair<sup>®</sup>) treatment

Johansson, S. G. O.; Nopp, Anna; Öman, H.; Ankerst, Jaro; Cardell, Lars-Olaf; Grönneberg, R.; Matsols, H; Rudblad, Stig; Strand, V.; Stålenheim, Gunnemar

doi:10.1111/j.1398-9995.2009.02051.x

Cited by 75 publications

(80 citation statements)

References 12 publications

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“…However, added together, they represented 11–14% of the ‘total IgE’, i.e. much higher than the 3.8% for nonresponders [2]. For clinical reasons, it was decided to give them Xolair.…”

Section: Discussionmentioning

confidence: 99%

“…1), since Xolair is only effective in patients with a low percentage (≤ 1%) of IgE antibodies [2]. In addition, all IgE antibodies to non-cross-reacting allergens that the patient could be simultaneously exposed to must be included in the IgE antibody fraction [9].…”

Section: Discussionmentioning

confidence: 99%

“…The patients’ allergen sensitivity, CD-sens [4,5], and the number of IgE and FcεRImolecules per basophil [2] were calculated as described. …”

Section: Methodsmentioning

confidence: 99%

“…These patients are likely to need limited dosages of Xolair in contrast to patients with high levels of serum IgE (>700 kU/l). On the other hand, in patients with low concentrations, the clinically relevant IgE antibody fraction might be quite large, which might be a problem in reaching the optimal dosage of Xolair [2]. …”

Section: Introductionmentioning

confidence: 99%

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Xolair Is Effective in Allergics with a Low Serum IgE Level

Ankerst¹,

Nopp²,

Johansson³

et al. 2009

Int Arch Allergy Immunol

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Background: Two atopic patients suffering from severe allergy difficult to handle by conventional medication were given Xolair despite an IgE level <30 kU/l. Methods: Increasing dosages were given and monitored by clinical evaluation and CD-sens to clinically relevant allergens. The patients’ IgE antibody fractions were 11–14%. Results: Xolair dosages extrapolated from a recommended dose for IgE of 30–75 kU/l were adapted to the patients’ IgE body pool but had very little effect. The double dose resulted in some clinical improvement and a decrease in CD-sens. However, not until the dose was doubled again did the patients become symptom free, although 1 patient needed some additional drugs but no oral steroids. CD-sens turned negative to 5 of the 7 tested allergens. Conclusions: Xolair is most useful also in atopics with an IgE level <30 kU/l. The dose must be adjusted to the size of the IgE antibody fraction adding all non-cross-reacting, clinically relevant specificities.

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“…However, added together, they represented 11–14% of the ‘total IgE’, i.e. much higher than the 3.8% for nonresponders [2]. For clinical reasons, it was decided to give them Xolair.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The patients’ allergen sensitivity, CD-sens [4,5], and the number of IgE and FcεRImolecules per basophil [2] were calculated as described. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Xolair Is Effective in Allergics with a Low Serum IgE Level

Ankerst¹,

Nopp²,

Johansson³

et al. 2009

Int Arch Allergy Immunol

Self Cite

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“…37) Moreover, anti-IgE antibody omalizumab (Xolair\[R\]) eliminated total IgE level in patients with allergic asthma. 38) In our study, total IgE level had no difference between Der m and FIP-fve/Der m group (Fig. 6(B)).…”

Section: Discussionmentioning

confidence: 43%

Alleviation of Dermatophagoides microceras-induced allergy by an immunomodulatory protein, FIP-fve, from Flammulina velutipes in mice

Chang

Hsiao

Hung

et al. 2015

Bioscience, Biotechnology, and Biochemistry

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Correlation of Serum Levels of IgE Autoantibodies Against BP180 With Bullous Pemphigoid Disease Activity

et al. 2017

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IMPORTANCE Bullous pemphigoid (BP) is by far the most frequent autoimmune blistering disease. The presence of IgE autoantibodies against the transmembrane protein BP antigen 2 (BP180, type XVII collagen) has previously been reported in 22% to 100% of BP serum samples, and the pathogenic relevance of anti-BP180 IgE has been suggested in various experimental models and by the successful use of omalizumab in individual patients with BP. OBJECTIVES To determine the rate of anti-BP180-reactive IgE in BP, to evaluate the diagnostic relevance of anti-BP180 IgE in BP, and to correlate anti-BP180 IgE with disease activity and the clinical phenotype of patients with BP. DESIGN, SETTING, AND PARTICIPANTS This case-control cohort study examined 3 groups of patients with BP. Sixty-five patients with BP underwent an enzyme-linked immunosorbent assay for IgE antibodies against the 16th noncollagenous domain of BP180 (NC16A); 52 consecutive patients with BP underwent clinical evaluation with the Bullous Pemphigoid Disease Activity Index (BPDAI); and 36 patients with BP without anti-BP180 NC16A IgG reactivity underwent evaluation of the diagnostic importance of serum anti-BP180 IgE. In addition, 49 age-matched control individuals with noninflammatory dermatoses, 127 controls undergoing allergy testing for IgE levels, and 30 controls with pemphigus vulgaris or pemphigus foliaceus were included for comparison. Patients were seen at a university clinic from January 1, 2008, to July 31, 2014. MAIN OUTCOMES AND MEASURES Serum anti-BP180 NC16A IgE and IgG levels and BPDAI scores.RESULTS Of 117 patients with BP (69 women and 48 men), anti-BP180 NC16A serum IgE was detected in 47 (40.2%) and correlated with disease activity as measured by total BPDAI (r = 0.918; P = .06). An intraindividual correlation of anti-BP180 NC16A serum levels with the total BPDAI was observed during the course of the disease in 10 randomly selected patients with BP (r = 0.983; P = .003). Although no association of circulating BP180 NC16A IgE antibodies with urticarial or erythematous lesions was observed (r = 0.481; P = .31), the presence of IgG anti-BP180 NC16A antibodies was associated with the occurrence of erosions and blisters (r = 0.985; P = .006) but not urticarial and erythematous lesions (r = 0.632; P = .23). Assaying for anti-BP180 IgE increased the diagnostic sensitivity by only 2.2% (1 of 46 serum samples) when combined with the IgG anti-BP180 enzyme-linked immunosorbent assay. CONCLUSIONS AND RELEVANCEAlthough detection of serum anti-BP180 IgE is not of diagnostic importance, it may be relevant for therapeutic decisions (eg, the use of anti-IgE treatment). The correlation of serum anti-BP180 NC16A IgE levels with disease activity in patients with BP supports the notion that anti-BP180 IgE is of pathogenic relevance. Our observation that IgG anti-BP180 antibodies are related to the occurrence of blisters and erosions may encourage further studies on the association of fine autoantibody reactivities with clinical features of BP.

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The size of the disease relevant IgE antibody fraction in relation to ‘total‐IgE’ predicts the efficacy of anti‐IgE (Xolair^®) treatment

Cited by 75 publications

References 12 publications

Xolair Is Effective in Allergics with a Low Serum IgE Level

Xolair Is Effective in Allergics with a Low Serum IgE Level

Alleviation of Dermatophagoides microceras-induced allergy by an immunomodulatory protein, FIP-fve, from Flammulina velutipes in mice

Correlation of Serum Levels of IgE Autoantibodies Against BP180 With Bullous Pemphigoid Disease Activity

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The size of the disease relevant IgE antibody fraction in relation to ‘total‐IgE’ predicts the efficacy of anti‐IgE (Xolair®) treatment

Cited by 75 publications

References 12 publications

Xolair Is Effective in Allergics with a Low Serum IgE Level

Xolair Is Effective in Allergics with a Low Serum IgE Level

Alleviation of Dermatophagoides microceras-induced allergy by an immunomodulatory protein, FIP-fve, from Flammulina velutipes in mice

Correlation of Serum Levels of IgE Autoantibodies Against BP180 With Bullous Pemphigoid Disease Activity

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The size of the disease relevant IgE antibody fraction in relation to ‘total‐IgE’ predicts the efficacy of anti‐IgE (Xolair^®) treatment