Bronchial asthma is a chronic inflammatory disease of the airways which is recognized as a highly prevalent health problem in both the developed and the developing world, with significant human and economic consequences.Allergy is acknowledged as a major risk factor for
asthma. The pathogenetic aspects of allergic
asthma are characterized by airway
inflammation with infiltration of mast cells, basophils, eosinophils, monocytes and T helper type 2 lymphocytes, along with the isotype switching of B cells to generate
immunoglobulins of the
immunoglobulin E (
IgE) class. Increased
asthma severity is not only associated with recurrent hospitalization and increased mortality but also with higher social costs.Inhaled
corticosteroids are the standard anti-inflammatory medication and are effective for most
asthma patients, but there is a substantial number of asthmatics who remain symptomatic even after receiving treatment with inhaled
corticosteroids and long-acting beta(2)-adrenoceptor agonists (beta(2)-agonists), and sometimes are in need of systemic
corticosteroids to control the disease. These patients account for about 50% of the healthcare costs of
asthma.New treatment options more specifically targeting the pathophysiologic events causing development of
asthma are therefore required in these patients.A novel therapeutic approach to
asthma and other allergic
respiratory diseases involves interference with the action of
IgE and prevention of subsequent
IgE-mediated responses.Omalizumab is a humanized recombinant monoclonal
anti-IgE antibody developed for the treatment of allergic diseases, with clear efficacy in adolescent and adult patients with moderate-to-severe allergic
asthma. This non-anaphylactogenic
anti-IgE antibody inhibits
IgE functions by blocking free serum
IgE and inhibiting their binding to cellular receptors.
Omalizumab therapy is well tolerated and significantly improves symptoms and disease control, and reduces
asthma exacerbations and the need to use high dosages of inhaled
corticosteroids. Moreover,
omalizumab improves quality of life of patients with severe persistent allergic
asthma that is inadequately controlled by currently available
asthma medications. In conclusion,
omalizumab may fulfill an important need in patients with moderate-to-severe
asthma inadequately controlled with inhaled
corticosteroids +beta(2)-agonists.