Anti-IgE-antikörper als präventive behandlung

The immunoglobulin E (IgE) antibody plays a central role in allergic inflammatory responses, such as those which characterize allergic rhinitis and bronchial asthma. Recently, a humanized monoclonal anti-IgE antibody (omalizumab) has been developed. Omalizumab binds to circulating human IgE with an affinity comparable to the interaction between IgE and its high-affinity Fc receptors (FcεRI), but it does not interact with IgE already bound by FcεRI on mast cells and basophils nor with IgE bound by the low-affinity Fc receptors (FcεRII) on various other cell types. Studies of omalizumab in the treatment of allergic asthma and allergic rhinitis were performed in children as well as in adults according to double-blind, randomized, placebo-controlled protocols. All these studies showed that administration of omalizumab resulted in reduced symptom scores, reduced requirements for medication, and a reduced asthma exacerbation rate. Therefore, anti-IgE offers a new approach to interfere with the pathophysiological mechanisms of allergic diseases in a preventive way. However, the effects of anti-IgE antibodies appear to diminish when administration has been finished. Also, there is a lack of long-term experience with this therapy.