Abstract
Increased asthma severity is not only associated with enhanced recurrent hospitalization and mortality but also with higher social costs.Several cases of asthma are atopic in nature, with the trigger for acute asthma attacks and chronic worsening of inflammation being allergens inducing an immune, IgE mediated response.Anti-inflammatory treatments are effective for most of asthma patients, but there are subjects whose disease is incompletely controlled by inhaled or systemic corticosteroids and these patients account for about 50% of the healthcare costs of asthma.Omalizumab is a biological engineered, humanized recombinant monoclonal anti-IgE antibody developed for the treatment of allergic diseases and with clear efficacy in adolescent and adult patients with severe allergic asthma. The anti-IgE antibody inhibits IgE functions blocking free serum IgE and inhibiting their binding to cellular receptors. By reducing serum IgE levels and IgE receptor expression on inflammatory cells in the context of allergic cascade, omalizumab has demonstrated to be a very useful treatment of atopic asthma, improving quality of life of patients with severe persistent allergic asthma that is inadequately controlled by currently available asthma medications. Several trials have demonstrated that this therapy is well tolerated and significantly improves symptoms and disease control, reducing asthma exacerbations and the need to use high dosage of inhaled corticosteroids.
Highlights
A body of evidence suggests that bronchial asthma and other allergic diseases have become more common worldwide in recent years and are recognized as a higly prevalent health problem in the developed and developing world [1,2,3,4,5,6]
Review It is well known that immunoglobulin E (IgE) antibodies, Th2 derived cytokines and eosinophils play a major role in the development of chronic airway inflammation, which is observed even in subjects with mild disease [9,10,11,12]
Airway inflammation plays a central role in the pathogenesis of bronchial asthma and is associated with an increase in airway responsiveness to several trigger factors such as aeroallergens which induce bronchoconstriction in atopic asthma patients, acting sometimes in cooperation with other trigger factors such as viruses and air pollution
Summary
A body of evidence suggests that bronchial asthma and other allergic diseases have become more common worldwide in recent years and are recognized as a higly prevalent health problem in the developed and developing world [1,2,3,4,5,6]. Omalizumab in allergic asthma In several clinical controlled trials omalizumab resulted to be able to reduce asthma-related symptoms, to decrease corticosteroid use and to improve quality of life of asthmatic patients [28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,48,49,50,51] and some of these studies show the benefits of anti-IgE as add-on therapy in patients with severe persistent asthma who are inadequately controlled by anti-asthma pharmacological therapy (Additional file 1). This is relevant for patients who are unable to avoid allergen exposure in their place of work
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