Experience with monoclonal antibodies in allergic mediated disease: seasonal allergic rhinitis.
Current therapies for the treatment of seasonal allergic rhinitis include allergen avoidance; pharmacologic interventions such as sympathomimetics, topical and systemic cortico-steroids, and chromones; and immunotherapy. In an attempt to create a novel therapy, therapeutic agents have been designed to inhibit IgE responses that are intimately involved in the induction of the allergic response. Omalizumab, a humanized monoclonal antibody against IgE, represents a novel therapeutic intervention for seasonal allergic rhinitis. Complex formation of omalizumab with serum-free IgE reduces the amount of IgE available for binding to effector cells and thus has the potential to reduce IgE-mediated allergic symptoms. Clinical trial results confirmed that omalizumab reduces free IgE to a level that is associated with suppressed allergic symptoms, reduces concomitant rescue medication use, and improves rhinitis-specific quality of life. Patients treated with omalizumab during one pollen season can be re-treated during the subsequent season with minimal risk of adverse events. Omalizumab is non-allergen-specific and does not induce acute anaphylaxis because of the lack of IgE crosslinking with basophil- or mast-cell-bound IgE. Furthermore, subcutaneous or intravenous administration of omalizumab does not invoke the generation of anti-omalizumab antibodies. Thus, omalizumab represents a novel agent that should assist in the treatment of allergic rhinitis.
Casale
T B
TB
Creighton University, Omaha, Nebraska 68231, USA.
D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D006801:Humans; D000069444:Omalizumab; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*
D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab