Anti-IgE in the treatment of allergic disorders in pediatrics.
OBJECTIVE
Neutralization of IgE antibodies is a conceptually new approach for the treatment of allergic diseases. This article reviews current concepts of anti-IgE therapy, with a focus on recent studies that provide insights into underlying mechanisms. Findings of the most recent clinical trials of anti-IgE in the treatment of allergic disorders are discussed.


RESULTS
Anti-IgE therapy in allergic asthma has been evaluated mostly in adults, but some studies have documented potential clinical efficacy in children and adolescent patients with moderate to severe uncontrolled asthma despite maximal conventional therapy. Pilot investigations have revealed some promising results regarding the use of anti-IgE in the treatment of other atopic diseases and as an adjunctive therapy in conjunction with allergen-specific immunotherapy. Recent work has provided novel insights into the kinetics of cellular responses to anti-IgE treatment and has identified significant anti-IgE effects on both basophils and dendritic cells, suggesting significant roles for these cells as effectors of IgE-mediated disease.


CONCLUSIONS
Studies of anti-IgE therapy have significantly advanced our understanding of IgE-mediated disease mechanisms and have demonstrated clinical efficacy in the treatment of allergic asthma in adults and children. Further studies are needed in children to evaluate long-term safety and to better define its potential use in allergic diseases other than asthma.
Division of Immunology, Children's Hospital Boston, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115, USA. ari.fried@childrens.harvard.edu
Ari J
AJ
Fried
Hans C
HC
Oettgen
D018926:Anti-Allergic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000188:drug therapy; D002648:Child; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000188:drug therapy*; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use*; D000069444:Omalizumab; D010372:Pediatrics
D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; C026408:anti-IgE antibodies; D000069444:Omalizumab