The current scientific research is continuously aiming at identifying new therapeutic targets with the purpose of modifying the immune response to
allergens. The evolution in immunological methods has led to the identification of
immunoglobulin E (
IgE) as both a diagnostic
biomarker and potential therapeutic target in allergic diseases, such as
allergic rhinitis. Allergen immunotherapy has been used for more than 100 years to treat allergic diseases and it is today considered the only disease-modifying treatment capable of inducing a long-lasting immunological and clinical tolerance toward the causal
allergen. During the past 20 years, major advances have been made in understanding the molecular and cellular mechanisms of
allergen tolerance in humans. Moreover, there has been considerable progress in
allergen extract modifications and additions to standard extracts. The recognition that
IgE plays a pivotal role in basic regulatory mechanisms of allergic
inflammation has recently stimulated research into the therapeutic potential of directly targeting this antibody.
Omalizumab, the most advanced humanized
anti-IgE monoclonal antibody, is currently approved for the treatment of uncontrolled allergic
asthma and
chronic spontaneous urticaria. Interesting results also arise from studies in which
omalizumab was administered in patients with
allergic rhinitis. The aim of this review is to provide an update on current findings on immunological and clinical effects of allergen immunotherapy and
anti-IgE therapy, which have been shown to have synergistic modes of action for the treatment of
allergic rhinitis.