The
immunoglobulin E (
IgE) antibody plays a central role in the allergic immune responses, such as those which characterise allergic
bronchial asthma. The ability to reduce circulating
IgE by using
anti-IgE antibodies represents a novel therapeutic approach for
IgE-mediated allergic diseases.
Omalizumab (
rhuMAb-E25/
Xolair Genentech, USA/Tanox, Inc., USA/Novartis Pharma AG, Switzerland) is a non-anaphylactogen humanised murine
monoclonal antibody which binds to circulating
IgE.
Therapeutic use of an
anti-IgE antibody in the treatment of
asthma was first suggested in preliminary studies in which
omalizumab demonstrated efficacy in attenuating both the early- and late-phase bronchial responses to inhaled
allergens in atopic subjects. Treatment with
omalizumab has demonstrated both a significant beneficial effect on a number of measures, and a favourable safety profile. It reduces the frequency of
asthma exacerbations and the need for inhaled
corticosteroids (ICSs), and improves
asthma symptoms, lung function and quality of life. The
anti-IgE approach to
asthma treatment has a number of further potential advantages, such as the treatment of other concomitant atopic diseases (
allergic conjunctivitis and
rhinitis,
atopic dermatitis and
food allergy), regardless of the type of allergic sensitisation (seasonal or perennial). On the basis of several studies,
omalizumab is likely to provide a new strategy for treating atopic
asthma.