Journal Information
Vol. 42. Issue 5.
Pages 241-245 (May 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 5.
Pages 241-245 (May 2006)
Review Article
Full text access
Anti-Immunoglobulin E, a Monoclonal Antibody to Treat Respiratory Disorders
Visits
6040
P. Cabrera-Navarroa,
Corresponding author
pcabnav@gobiernodecanarias.org

Correspondence: Dr. P. Cabrera-Navarro. Servicio de Neumología. Hospital Universitario Dr. Negrín. Barranco de la Ballena, s/n. 35020 Las Palmas de Gran Canaria. Las Palmas. España
a Servicio de Neumología, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain.
This item has received
Article information

Omalizumab is a monoclonal antibody that interrupts allergic reaction—irrespective of the nature of the allergen—by blocking free immunoglobulin E (IgE). The IgE is thus prevented from attaching to cell receptors and setting in motion an allergic cascade of inflammatory mediators. Other interesting biological effects of omalizumab are that it downregulates IgE receptor expression on cell membranes and reduces bronchial eosinophilic infiltration. Clinical trials have demonstrated omalizumab's efficacy and safety in treating most allergic disorders. However, given its high cost, omalizumab is generally reserved for more severe cases of asthma and for asthma that responds poorly to conventional treatments.

Key words:
Asthma
Anti-immunoglobulin E
Omalizumab
Monoclonal antibodies

El omalizumab es un anticuerpo monoclonal que interrumpe la reacción alérgica, independientemente de cuál sea el alérgeno, bloqueando la inmunoglobulina E (IgE) libre, de forma que le impide unirse a sus receptores celulares y poner en marcha la cascada de mediadores de la inflamación alérgica. Además, presenta otros efectos biológicos de especial interés, como disminuir la expresión de los receptores de membrana para la IgE y la infiltración eosinófila bronquial. Los ensayos clínicos han demostrado su utilidad clínica en la mayoría de las enfermedades alérgicas, junto con una gran seguridad terapéutica. No obstante, su alto precio hace que se reserve para los casos de asma de mayor gravedad y mala respuesta al tratamiento convencional.

Palabras clave:
Asma
Anti-IgE
Omalizumab
Anticuerpos monoclonales
Full text is only aviable in PDF
REFERENCES
[1]
B Burrows, FD Martínez, A Halonen, RA Barbee, MG Cline.
Association of asthma with serum IgE levels and skin test reactivity to allergens.
N Engl J Med., 320 (1989), pp. 271-277
[2]
MR Sears, B Burrows, EM Flannery, GP Herbison, CJ Hewitt, MD Holdaway.
Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children.
N Engl J Med., 325 (1991), pp. 1067-1071
[3]
PA Greenberger.
Allergic bronchopulmonary aspergillosis.
J Allergy Clin Immunol., 110 (2002), pp. 685-692
[4]
R Torres, C Picado, F de Mora.
Descubriendo el asma de origen alérgico a través del ratón. Un repaso a la patogenia de los modelos de asma alérgica en el ratón y su similitud con el asma alérgica humana.
Arch Bronconeumol., 41 (2005), pp. 141-152
[5]
MJ Leckie, A Ten Brinke, J Khan, Z Diamant, BJ O'Connor, CM Walls, et al.
Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response.
Lancet, 356 (2000), pp. 2144-2148
[6]
S Easthope, B Jarvis.
Omalizumab.
Drugs, 61 (2001), pp. 253-260
[7]
PN Nelson, GM Reynolds, EE Waldron, E Ward, K Giannopoulos, PG Murray.
Monoclonal antibodies.
Mol Pathol., 53 (2000), pp. 111-117
[8]
FC Breedveld.
Therapeutic monoclonal antibodies.
Lancet, 355 (2000), pp. 735-740
[9]
KM Beeh, M Ksoll, R Buhl.
Elevation of total serum immunoglobulin E is associated with asthma in nonallergic individuals.
Eur Respir J., 16 (2000), pp. 609-614
[10]
SS Saini, DW MacGlashan Jr, SA Sterbinsky, A Togias, DC Adelman, LM Lichtenstein, et al.
Down-regulation of human basophil IgE and FC epsilon RI alpha surface densities and mediator release by anti-IgE-infusions is reversible in vitro and in vivo.
J Immunol., 162 (1999), pp. 5624-5630
[11]
HC Oettgen, RS Geha.
IgE in asthma and atopy: cellular and molecular connections.
J Clin Invest., 104 (1999), pp. 829-835
[12]
LG Presta, SJ Lahr, RL Shields, JP Porter, CM Gorman, BM Fendly, et al.
Humanization of an antibody directed against IgE.
J Immunol., 151 (1993), pp. 2623-2632
[13]
TW Chang.
The pharmacological basis of anti-IgE therapy.
Nat Biotechnol., 18 (2000), pp. 157-162
[14]
D Thomas, R Saban, P Jardieu.
Inhibition of allergic reactions with antibodies to IgE.
Int Arch Allergy Immunol., 107 (1995), pp. 308-312
[15]
FJ Malveaux, MC Conroy, NF Adkinson Jr, LM Lichtenstein.
IgE receptors on human basophils. Relationship to serum IgE concentration.
J Clin Invest., 62 (1978), pp. 176-181
[16]
K Rajakulasingam, S Till, S Ying, M Humbert, J Barkans, M Sullivan, et al.
Increased expression of high affinity IgE (FcepsilonRI) receptor-alpha chain mRNA and protein-bearing eosinophils in human allergen-induced atopic asthma.
Am J Respir Crit Care Med., 158 (1998), pp. 233-240
[17]
DW MacGlashan Jr, BS Bochner, DC Adelman, PM Jardieu, A Togias, J McKenzie-White, et al.
Down-regulation of Fc(epsilon)RI expression on human basophils during in vivo treatment of atopic patients with anti-IgE antibody.
J Immunol., 158 (1997), pp. 1438-1445
[18]
R Djukanovic, SJ Wilson, M Kraft, NN Jarjour, M Steel, KF Chung, et al.
Effects of treatment with anti-immunoglobulin E antibody omalizumab on airway inflammation in allergic asthma.
Am J Respir Crit Care Med., 170 (2004), pp. 583-593
[19]
ES Schulman.
Development of a monoclonal anti-immunoglobulin E antibody (omalizumab) for the treatment of allergic respiratory disorders.
Am J Respir Crit Care Med., 164 (2001), pp. S6-S11
[20]
LP Boulet, KR Chapman, J Cote, S Kalra, R Bhagat, VA Swystun, et al.
Inhibitory effects of an anti-IgE antibody E25 on allergen-induced early asthmatic response.
Am J Respir Crit Care Med., 155 (1997), pp. 1835-1840
[21]
JV Fahy, HE Fleming, HH Wong, JT Liu, JQ Su, J Reimann, et al.
The effect of an anti-IgE monoclonal antibody on the early-and late-phase responses to allergen inhalation in asthmatic subjects.
Am J Respir Crit Care Med., 155 (1997), pp. 1828-1834
[22]
TB Casale, J Condemi, C la Force, A Nayak, M Rowe, M Watrous, et al.
Omalizumab Seasonal Allergic Rhinitis Trail Group. Effect of omalizumab on symptoms of seasonal allergic rhinitis: a randomized controlled trial.
JAMA., 286 (2001), pp. 2956-2967
[23]
E Adelroth, S Rak, T Haahtela, G Aasand, L Rosenhall, O Zetterstrom, et al.
Recombinant humanized mAb-E25, an anti-IgE mAb, in birch pollen-induced seasonal allergic rhinitis.
J Allergy Clin Immunol., 106 (2000), pp. 253-259
[24]
H Plewako, M Arvidsson, K Petruson, I Oancea, K Holmberg, E Adelroth, et al.
The effect of omalizumab on nasal allergic inflammation.
J Allergy Clin Immunol., 110 (2002), pp. 68-71
[25]
AM Vignola, M Humbert, J Bousquet, LP Boulet, S Hedgecock, M Blogg, et al.
Efficacy and tolerability of anti-immunoglobulin E therapy with omalizumab in patients with concomitant allergic asthma and persistent allergic rhinitis: SOLAR.
[26]
G Hanf, O Noga, A O'Connor, G Kunkel.
Omalizumab inhibits allergen challenge-induced nasal response.
Eur Respir J., 23 (2004), pp. 414-418
[27]
P Chervinsky, T Casale, R Townley, I Tripathy, S Hedgecock, A Fowler-Taylor, et al.
Omalizumab, an anti-IgE antibody, in the treatment of adults and adolescents with perennial allergic rhinitis.
Ann Allergy Asthma Immunol., 91 (2003), pp. 160-167
[28]
H Milgrom, RB Fick Jr, JQ Su, JD Reimann, RK Bush, ML Watrous, et al.
Treatment of allergic asthma with monoclonal anti-IgE antibody. rhuMAb-E25 Study Group.
N Engl J Med., 341 (1999), pp. 1966-1973
[29]
M Soler, J Matz, R Townley, R Buhl, J O'Brien, H Fox, et al.
The anti-IgE antibody omalizumab reduces exacerbations and steroid requirement in allergic asthmatics.
Eur Respir J., 18 (2001), pp. 254-261
[30]
RF Lemanske Jr, A Nayak, M McAlary, F Everhard, A Fowler-Taylor, N Gupta.
Omalizumab improves asthma-related quality of life in children with allergic asthma.
Pediatrics., 100 (2002), pp. e55
[31]
S Holgate, J Bousquet, S Wenzel, H Fox, J Liu, J Castellsague.
Efficacy of omalizumab, an anti-immunoglobulin E antibody, in patients with allergic asthma at high risk of serious asthma-related morbidity and mortality.
Curr Med Res Opin., 17 (2001), pp. 233-240
[32]
J Corren, T Casale, Y Deniz, M Ashby.
Omalizumab, a recombinant humanized anti-IgE antibody, reduces asthma-related emergency room visits and hospitalizations in patients with allergic asthma.
J Allergy Clin Immunol., 111 (2003), pp. 87-90
[33]
J Bousquet, S Wenzel, S Holgate, W Lumry, P Freeman, H Fox.
Predicting response to omalizumab, an anti-IgE antibody, in patients with allergic asthma.
Chest, 125 (2004), pp. 1378-1386
[34]
J Bousquet, P Cabrera, N Berkman, R Buhl, S Holgate, S Wenzel, et al.
The effect of treatment with omalizumab, an anti-IgE antibody, on asthma exacerbations and emergency medical visits in patients with severe persistent asthma.
[35]
F Leynadier, O Doudou, H Gaouar, V le Gros, I Bourdeix, L Guyomarch-Cocco, et al.
Effect of omalizumab in health care workers with occupational latex allergy.
J Allergy Clin Immunol., 113 (2004), pp. 360-361
[36]
JV Fahy, DW Cockcroft, LP Boulet, HH Wong, F Deschesnes, EE Davis, et al.
Effect of aerosolized anti-IgE (E25) on airway responses to inhaled allergen in asthmatic subjects.
Am J Respir Crit Care Med., 160 (1999), pp. 1023-1027
[37]
N Gupta, M McAlary, A Fowler-Taylor.
Evaluation of long-term safety of the anti-IgE antibody, omalizumab, in children with allergic asthma.
Ann Allergy Asthma Immunol., 91 (2003), pp. 182-188
[38]
JA Fox, TE Hotaling, C Struble, J Ruppel, DJ Bates, MB Schoenhoff.
Tissue distribution and complex formation with IgE of an anti-IgE antibody after intravenous administration in cynomolgus monkeys.
J Pharmacol Exp Ther., 279 (1996), pp. 1000-1008
[39]
J Liu, P Lester, S Builder, SJ Shire.
Characterization of complex formation by humanized anti-IgE monoclonal antibody and monoclonal human IgE.
Biochemistry, 34 (1995), pp. 10474-10482
[40]
Y Oba, GA Salzman.
Cost-effectiveness analysis of omalizumab in adults and adolescents with moderate-to-severe allergic asthma.
J Allergy Clin Immunol., 114 (2004), pp. 265-269
[41]
M Humbert, R Beasley, J Ayres, R Slavin, J Hebert, J Bousquet, et al.
Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE.
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?