title: From IgE to clinical trials of allergic rhinitis.
abstract: The current scientific research is continuously aiming at identifying new therapeutic targets with the purpose of modifying the immune response to allergens. The evolution in immunological methods has led to the identification of immunoglobulin E (IgE) as both a diagnostic biomarker and potential therapeutic target in allergic diseases, such as allergic rhinitis. Allergen immunotherapy has been used for more than 100 years to treat allergic diseases and it is today considered the only disease-modifying treatment capable of inducing a long-lasting immunological and clinical tolerance toward the causal allergen. During the past 20 years, major advances have been made in understanding the molecular and cellular mechanisms of allergen tolerance in humans. Moreover, there has been considerable progress in allergen extract modifications and additions to standard extracts. The recognition that IgE plays a pivotal role in basic regulatory mechanisms of allergic inflammation has recently stimulated research into the therapeutic potential of directly targeting this antibody. Omalizumab, the most advanced humanized anti-IgE monoclonal antibody, is currently approved for the treatment of uncontrolled allergic asthma and chronic spontaneous urticaria. Interesting results also arise from studies in which omalizumab was administered in patients with allergic rhinitis. The aim of this review is to provide an update on current findings on immunological and clinical effects of allergen immunotherapy and anti-IgE therapy, which have been shown to have synergistic modes of action for the treatment of allergic rhinitis.
authors.affiliation: a 1 Department of Medicine, IRCCS-A.O.U. San Martino di Genova, Genoa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.affiliation: b 2 Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Marseglia
authors.affiliation: b 2 Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Castagnoli
authors.affiliation: b 2 Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Valsecchi
authors.affiliation: b 2 Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Tagliacarne
authors.affiliation: b 2 Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Caimmi
authors.affiliation: b 2 Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Licari
mesh_terms: D000485:Allergens / Q000737:chemistry / Q000276:immunology / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D065631:Rhinitis, Allergic / Q000276:immunology* / Q000628:therapy*
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: IgE; allergen immunotherapy; allergic rhinitis; omalizumab; sublingual immunotherapy