Omalizumab and the immune system: an overview of preclinical and clinical data.
OBJECTIVE
This review discusses the role of immunoglobulin (Ig)E in allergic disease, inhibition of IgE with omalizumab, and the consequences of IgE inhibition (both clinically and in terms of the effect on the immune system).


METHODS
Relevant publications obtained from a literature review.


METHODS
Relevant publications on IgE, allergic disease, and anti-IgE were critically evaluated.


RESULTS
IgE plays a key role in allergic diseases such as allergic asthma and allergic rhinitis. Its role in healthy individuals is less well defined. Treatment of allergic asthma and rhinitis with omalizumab, a humanized monoclonal anti-IgE antibody, causes a marked reduction in circulating free IgE levels. This has been shown to reduce symptoms and decrease the need for other medication in patients with these allergic diseases. Anti-IgE treatment with omalizumab did not cause any of the complications that might, in theory, be expected to result from reduction in circulating free IgE, such as adverse effects upon the immune system or other body systems.


CONCLUSIONS
The limited clinical data currently available suggest that this novel method of treatment for allergic asthma and rhinitis seems to be both effective and well tolerated in clinical use.
Department of Clinical Immunology, Karolinska Hospital, Stockholm, Sweden. s.g.o.johansson@ks.se
S G O
SG
Johansson
Tari
T
Haahtela
Paul M
PM
O'Byrne
D000888:Antibodies, Anti-Idiotypic / Q000494:pharmacology / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002986:Clinical Trials as Topic; D004353:Drug Evaluation, Preclinical; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000188:drug therapy*; D007107:Immune System / Q000187:drug effects; D007073:Immunoglobulin E / Q000737:chemistry / Q000276:immunology / Q000502:physiology; D018448:Models, Immunological; D000069444:Omalizumab
D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C026408:anti-IgE antibodies; D000069444:Omalizumab; D007073:Immunoglobulin E