哮喘联盟

   摘要
   IgE在过敏性哮喘的病理生理过程中发挥核心作用。奥玛珠单抗，一种人源性的抗IgE单克隆抗体，会与游离IgE特异性结合，进而阻止IgE与肥大细胞、抗原递呈细胞和其它炎症细胞的高亲和性FcεRI受体结合，从而中断过敏级联反应。
   奥玛珠单抗的临床疗效已经在许多临床试验（涉及中重度和重度过敏性哮喘的成人患者、青少年患者和儿童患者）中得到了验证。在这些临床试验中，相对于安慰剂组或高标准护理组，奥玛珠单抗可以减少哮喘的急性发作，减少哮喘症状，减少吸入糖皮质激素和急救药物的使用，改善生活质量。对“真实世界人群”的观察性研究也得出了相似的临床获益。源于随机临床试验和大型前瞻性队列研究的数据再次证明了奥玛珠单抗的长期安全性。奥玛珠单抗的剂量需要根据体重和血清IgE水平加以个体化，最近欧洲的剂量算法调整使得更多的患者能够接受该治疗。目前的及未来的研究将探索最佳的治疗时间、疗效的精确预测指标、及对非特异性哮喘和其它IgE介导的状况的疗效。
 

（苏欣 审校）
JAllergyClinImmunolPract.2014Sep-Oct;2(5):525-536.e1.doi:10.1016/j.jaip.2014.03.010. Epub 2014 Jun 11.

 

Omalizumab in asthma: an update on recent developments.
 

Humbert M1, Busse W2, Hanania NA3, Lowe PJ4, Canvin J5, Erpenbeck VJ6, Holgate S7.
 

ABSTRACT
IgE is central to the pathophysiology of allergic asthma. Omalizumab, a humanized anti-IgEmAb, specifically binds free IgE and interrupts the allergic cascade by preventing binding of IgE with its high-affinity FcεRI receptors on mast cells, antigen-presenting cells, and other inflammatory cells.
The clinical efficacy of omalizumab has been well documented in a number of clinical trials that involve adults, adolescents, and children with moderate-to-severe and severe allergic asthma. In these studies, omalizumab reduced exacerbations, asthma symptoms, inhaled corticosteroid and rescue medication use, and improved quality of life relative to placebo or best standard of care. Similar benefits have been reported in observational studies in "real-world" populations of patients. Results from recent pooled data from randomized clinical trials and from a large prospective cohort study provide reassurance about the long-term safety of omalizumab. Omalizumab dosing is individualized according to body weight and serum-IgE level, and recent adjustments to the dosing algorithm in Europe have enabled more patients to be eligible for treatment. Ongoing and future research is investigating the optimal duration of therapy, accurate predictors of response to treatment, and efficacy in nonatopic asthma as well as other IgE-mediated conditions.
 

JAllergyClinImmunolPract.2014Sep-Oct;2(5):525-536.e1.doi:10.1016/j.jaip.2014.03.010. Epub 2014 Jun 11.