title: Influence of Omalizumab on Allergen-Specific IgE in Patients with Adult Asthma.
abstract: BACKGROUND
  Omalizumab, an anti-immunoglobulin E (IgE) monoclonal antibody, inhibits the binding of circulating IgE to mast cells and basophils, resulting in fewer episodes of airway inflammation, asthma symptoms and exacerbations in patients with severe allergic asthma. Treatment of patients with asthma using omalizumab increases serum total IgE (tIgE) levels. However, little is known about the influence of omalizumab on allergen-specific IgE (sIgE).
  
  
  METHODS
  tIgE and sIgE in 47 adult patients with severe asthma were measured with a fluorescent enzyme immunoassay (ImmunoCAP-FEIA) before and after omalizumab treatment.
  
  
  RESULTS
  Treatment with omalizumab increased tIgE and sIgE levels. The increases in sIgE by class category after omalizumab treatment were positively correlated with baseline sIgE positivity before treatment. The mean changes in sIgE levels after omalizumab treatment were also correlated with baseline sIgE levels before treatment. The mean changes in tIgE levels were positively correlated with the mean changes in IgE levels against Dermatophagoides pteronyssinus, crude house dust, Japanese cedar and moth. Omalizumab markedly influenced the negative-to-positive seroconversion rate for IgE against Japanese cedar (30.8%), Candida (29.0%) and moth (28.0%). Finally, all patients with negative-to-positive seroconversion for Japanese cedar-specific IgE had cedar pollinosis before beginning omalizumab treatment.
  
  
  CONCLUSIONS
  The changes in sIgE levels after omalizumab treatment may be dependent on the baseline sIgE levels. Our data may indicate the presence of undetectable but functional sIgE.
authors.affiliation: Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Mizuma
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tanaka
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Uchida
authors.forename: Akiko
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Ryo
authors.initials: R
authors.lastname: Manabe
authors.forename: Hitomi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Naota
authors.initials: N
authors.lastname: Kuwahara
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kimura
authors.forename: Megumi
authors.initials: M
authors.lastname: Jinno
authors.forename: Shin
authors.initials: S
authors.lastname: Ohta
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsukura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsukara
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
authors.forename: Hironori
authors.initials: H
authors.lastname: Sagara
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000627:therapeutic use*
chemical_list: D000485:Allergens; D018927:Anti-Asthmatic Agents; D000069444:Omalizumab; D007073:Immunoglobulin E