IMMUNOGLOBULIN E IN PEDIATRIC ASTHMA: ADVANCES IN UNDERSTANDING AND MANAGEMENT

Abstract

Asthma, a pervasive chronic inflammatory ailment of the respiratory system, remains a global health conundrum. The Global Burden of Disease Study (GBD) of 2019 underscores its widespread impact, revealing that asthma afflicts 262 million individuals worldwide, translating into an age-standardized prevalence of 3,416 per 100,000 population. The incidence among children is particularly alarming, with nearly 14% of the global pediatric population diagnosed with the condition. This statistic positions asthma as the foremost chronic respiratory disease among children, a trend that is on the rise, especially across Asia and Europe, as evidenced by the International Study of Asthma and Allergies in Childhood (ISAAC). Characterized by variable airflow limitation, bronchial hyperresponsiveness, excessive mucus production, and airway inflammation leading to airway constriction, asthma’s multifaceted nature complicates its management. In the realm of immunology, Immunoglobulin E (IgE) has been identified as a pivotal player. Recognized officially as the fifth class of serum immunoglobulins during the 1968 WHO International Reference Center for Immunoglobulins conference in Lausanne, IgE’s crucial role in the pathophysiology of asthma has been rigorously studied. Serum IgE levels, both total and specific, have been proven instrumental in the diagnosis, treatment, and prevention of pediatric asthma. The landmark approval of Omalizumab by the US Food and Drug Administration in 2003 heralded a new era in the biologic management of asthma, targeting children aged six and above. This was followed by the development of Ligelizumab and Quilizumab, innovative anti-IgE medications currently under investigation for their potential to alleviate symptoms and decelerate the disease’s progression. The integration of Allergy Immunotherapy (AIT) alongside monoclonal antibody therapies like Omalizumab, Ligelizumab, and Quilizumab signifies a monumental shift toward personalized medicine in asthma care. These advances promise not only to ameliorate the quality of life for pediatric asthma patients but also to redefine the landscape of asthma management. Nonetheless, the quest for enhanced treatment modalities for young asthmatics necessitates further in-depth research. The burgeoning field of anti-IgE therapy, in concert with AIT, is poised to set new benchmarks in pediatric asthma management, steering us towards a future where asthma’s grip on children’s health is significantly loosened.