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Minerva Pneumologica 2006 September;45(3):153-9

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: Italian

Allergic bronchial asthma and the new immunological treatment with anti-IgE monoclonal antibodies (Omalizumab)

D’Amato G.

Divisione di Malattie Respiratorie e Allergiche Dipartimento di Malattie Respiratorie Azienda Ospedaliera ad Alta Specialità di Rilievo Nazionale A. Cardarelli, Napoli


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Given that IgEs are antibodies involved in the allergic reactions that constitute the pathogenetic substrate of atopic asthma, it is reasonable to think of the IgEs and their synthesis as an optimal therapeutic target for the treatment of allergic asthma, especially that of a severe degree. From that point of view a new approach to the treatment of IgE mediated asthma consists of the anti-IgEs (Omalizumab), humanised murine monoclonal antibodies which, administered subcutaneously, Interact with the circulating IgEs and prevent them from binding with the high and low affinity receptors present on the inflammatory cells such as mastocytes, basophils etc. It follows that there is neither mastocyte degranulation with the release of already synthesised chemical mediators such as histamine, nor the synthesis of new chemical mediators (cysteinyl-leukotriene, prostaglan-dins etc.) and the consequent sequence of events that determines the inflammatory background of asthma. The immune microcomplexes that result, consisting of IgEs bound to monoclonal anti-IgEs, are then taken up and eliminated by the reticulo-histiocyte system. It has also been observed that omalizumab reduces cutaneous reactivity towards sensitising allergens, reduces early and late bronchial inflammatory responses towards aeroallergens, improves the quality of life of asthmatic patients and reduces the risk of mortality from asthma. It is considered in fact that the severity of asthma is connected with the concentration of receptors for high affinity IgE and this concentration is reduced by omalizumab.

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