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Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives

Konstantinos Samitas, Vasiliki Delimpoura, Eleftherios Zervas, Mina Gaga
European Respiratory Review 2015 24: 594-601; DOI: 10.1183/16000617.00001715
Konstantinos Samitas
17th Respiratory Dept and Asthma Centre, Athens Chest Hospital “Sotiria”, Athens, Greece
2Cellular Immunology Laboratory, Division of Cell Biology, Centre for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Vasiliki Delimpoura
17th Respiratory Dept and Asthma Centre, Athens Chest Hospital “Sotiria”, Athens, Greece
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Eleftherios Zervas
17th Respiratory Dept and Asthma Centre, Athens Chest Hospital “Sotiria”, Athens, Greece
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Mina Gaga
17th Respiratory Dept and Asthma Centre, Athens Chest Hospital “Sotiria”, Athens, Greece
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Abstract

Asthma is a disorder of the airways involving various inflammatory cells and mediators and characterised by bronchial hyperresponsiveness, chronic inflammation and structural alterations in the airways, also known as remodelling. IgE is an important mediator of allergic reactions and has a central role in allergic asthma pathophysiology, as it is implicated in both the early and late phase allergic response. Moreover, clinical and mechanistic evidence has lately emerged, implicating IgE in the development of airway remodelling. The use of monoclonal antibodies targeting IgE, such as omalizumab, has proven very effective in improving respiratory symptoms and quality of life, while reducing asthma exacerbations, emergency room visits and the use of systemic corticosteroids in allergic severe asthma. These effects are believed to be mainly mediated by omalizumab's inhibitory effect on the initiation and further propagation of the allergic inflammation cascade. However, there is evidence to suggest that anti-IgE treatment remains effective long after it has been discontinued. In part, these findings could be attributed to the possible ameliorating effects of anti-IgE treatment on airway remodelling. In this review, we discuss recent findings supporting the notion that anti-IgE treatment modulates the complex immune responses that manifest clinically as asthma and ameliorates airway remodelling changes often observed in allergic severe asthma phenotypes.

Abstract

Anti-IgE treatment suppresses the inflammatory airway response and markers of remodelling in allergic asthma http://ow.ly/Som4i

Footnotes

  • Conflict of interest: Disclosures can be found alongside the online version of this article at err.ersjournals.com

  • Provenance: Submitted article, peer reviewed.

  • Received February 16, 2015.
  • Accepted March 5, 2015.
  • Copyright ©ERS 2015.

ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives
Konstantinos Samitas, Vasiliki Delimpoura, Eleftherios Zervas, Mina Gaga
European Respiratory Review Dec 2015, 24 (138) 594-601; DOI: 10.1183/16000617.00001715

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Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives
Konstantinos Samitas, Vasiliki Delimpoura, Eleftherios Zervas, Mina Gaga
European Respiratory Review Dec 2015, 24 (138) 594-601; DOI: 10.1183/16000617.00001715
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