title: The anti-inflammatory effects of omalizumab confirm the central role of IgE in allergic inflammation.
abstract: Anti-IgE therapy with omalizumab reduces serum levels of free IgE and downregulates expression of IgE receptors (Fc epsilonRI) on mast cells and basophils. In the airways of patients with mild allergic asthma, omalizumab reduces Fc epsilonRI+ and IgE+ cells and causes a profound reduction in tissue eosinophilia, together with reductions in submucosal T-cell and B-cell numbers. In patients with seasonal allergic rhinitis, omalizumab inhibits the allergen-induced seasonal increases in circulating and tissue eosinophils. Omalizumab decreases Fc epsilonRI expression on circulating dendritic cells, which might lead to a reduction in allergen presentation, T(H)2 cell activation, and proliferation. As a systemic anti-IgE agent, omalizumab has demonstrated clinical efficacy in patients with moderate and severe allergic asthma and in those with seasonal and perennial allergic rhinitis, as well as in patients with concomitant allergic asthma and allergic rhinitis. The anti-inflammatory effects of omalizumab at different sites of allergic inflammation and the clinical benefits of anti-IgE therapy in patients with allergic asthma and allergic rhinitis emphasize the fundamental importance of IgE in allergic inflammation.
authors.affiliation: RCMB Research Division, Southampton General Hospital, United Kingdom. sth@soton.ac.uk
authors.forename: Stephen
authors.initials: S
authors.lastname: Holgate
authors.forename: Thomas
authors.initials: T
authors.lastname: Casale
authors.forename: Sally
authors.initials: S
authors.lastname: Wenzel
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet
authors.forename: Yamo
authors.initials: Y
authors.lastname: Deniz
authors.forename: Colin
authors.initials: C
authors.lastname: Reisner
mesh_terms: D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000188:drug therapy*; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007073:Immunoglobulin E / Q000187:drug effects / Q000276:immunology*; D007249:Inflammation / Q000276:immunology*; D000069444:Omalizumab; D017455:Receptors, IgE / Q000187:drug effects* / Q000276:immunology; D012220:Rhinitis / Q000188:drug therapy
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017455:Receptors, IgE; D000069444:Omalizumab; D007073:Immunoglobulin E