title: Targeting IgE in Severe Atopic Dermatitis with a Combination of Immunoadsorption and Omalizumab.
abstract: Patients with atopic dermatitis (AD) tend to have greatly elevated levels of serum immunoglobulin E (IgE). However, the role of IgE in the pathogenesis of AD is debated. This investigator-initiated open-label pilot study evaluates an anti-IgE-treatment approach by combining extracorporeal immunoadsorption and anti-IgE antibody omalizumab in 10 patients with severe, therapy-refractory AD. IgE levels decreased after immunoadsorption and decreased continuously in all patients during anti-IgE therapy. The reverse trend was observed during 6 months follow-up without treatment. In parallel with these observations, an improvement in AD was observed during the treatment period, with aggravation during follow-up. Further research is needed, based on the principle of reducing IgE levels in order to improve clinical symptoms, using a combination anti-IgE treatment approach, adjusted according to IgE levels.
authors.affiliation: Department of Dermatology and Allergy, Technische Universität München (TUM), Biedersteiner Str. 29, DE-80802 Munich, Germany. zink@lrz.tum.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Zink
authors.forename: Anna
authors.initials: A
authors.lastname: Gensbaur
authors.forename: Michael
authors.initials: M
authors.lastname: Zirbs
authors.forename: Florian
authors.initials: F
authors.lastname: Seifert
authors.forename: Isabel Leon
authors.initials: IL
authors.lastname: Suarez
authors.forename: Vagkan
authors.initials: V
authors.lastname: Mourantchanian
authors.forename: Stephan
authors.initials: S
authors.lastname: Weidinger
authors.forename: Martin
authors.initials: M
authors.lastname: Mempel
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
authors.forename: Markus
authors.initials: M
authors.lastname: Ollert
mesh_terms: D000328:Adult; D000368:Aged; D018926:Anti-Allergic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000009:adverse effects; D003131:Combined Modality Therapy; D003876:Dermatitis, Atopic / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007163:Immunosorbent Techniques / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D015415:Biomarkers; D000069444:Omalizumab; D007073:Immunoglobulin E