No abstract available.
Antibodies, Anti-Idiotypic ; Antibodies, Monoclonal, Humanized ; Urticaria ; Omalizumab

Atopic dermatitis (AD) is a chronic cutaneous inflammatory disease. Various categories of therapeutic medications are used for treating AD. Omalizumab is a monoclonal anti-IgE antibody that binds to IgE molecules at the high-affinity receptor (FcepsilonRI) binding site. Therefore, omalizumab can be used as a potential new systemic treatment agent for recalcitrant AD patients with elevated IgE levels. A 34-year-old man had been treated for AD with several topical and oral agents. However, he was refractory to these therapies and his serum IgE levels were very high. We treated him with omalizumab. After 8 months of the treatment, his symptoms were notably improved and the SCORAD index was decreased. Thus, we report on the first case of recalcitrant AD that was successfully treated with omalizumab in Korea.
Adult ; Antibodies, Anti-Idiotypic ; Antibodies, Monoclonal, Humanized ; Binding Sites ; Dermatitis, Atopic ; Humans ; Immunoglobulin E ; Korea ; Omalizumab

Food allergy has increased dramatically in prevalence over the past decade in westernized countries, and is now a major public health problem. Unfortunately for patients with food allergy, there is no effective therapy beyond food allergen avoidance, and rapid medical treatment for accidental exposures. Recently, oral immunotherapy (OIT) has been investigated as a treatment for this problem. In this review, we will discuss the progress in developing OIT for food allergy, including a novel approach utilizing Xolair (anti-IgE monoclonal antibody, omalizumab) in combination with OIT. This combination may enhance both the safety and efficacy of oral immunotherapy, and could lead to a widely available and safe therapy for food allergy.
Antibodies, Anti-Idiotypic ; Antibodies, Monoclonal, Humanized ; Food Hypersensitivity ; Humans ; Immunotherapy ; Prevalence ; Public Health ; Omalizumab

Antibodies, Anti-Idiotypic ; therapeutic use ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; therapeutic use ; Humans ; Omalizumab ; Rhinitis, Allergic ; therapy

PURPOSE: Chronic urticaria (CU) is a common and debilitating disease, and the need for effective treatment has increased. Omalizumab may be an alternative regimen in patients with CU who do not respond to conventional treatments. The aim of this study is to investigate the efficacy and to observe the clinical results of omlizumab in patients with refractory CU. METHODS: We conducted a retrospective analysis of 26 patients with refractory CU who were treated with omalizumab. Omalizumab was administered every 2 or 4 weeks, depending on body weight and the total serum IgE level, for 24 weeks. RESULTS: Fourteen patients (53.8%) achieved remission after the treatment; they had a significantly higher prevalence of personal (P=0.033) and family history of allergic diseases (P=0.002) than those who did not achieve remission. During omalizumab treatment, the urticaria activity score declined significantly (12.11+/-1.97 to 2.7+/-4.23; P=0.001) and the CU-quality of life score improved significantly (34.65+/-13.58 to 60.88+/-11.11; P=0.004). There were significant decreases in the use of systemic steroids (42.3%-11.5%; P=0.027) and immunomodulators (65.4%-19.2%; P=0.002). The dose of antihistamines required to control CU also decreased significantly (215.66+/-70.06 to 60.85+/-70.53 mg/week of loratadine equivalents; P<0.001). No serious adverse event was noted. CONCLUSIONS: These findings suggest that omalizumab can be an effective and safe treatment in patients with refractory CU.
Antibodies, Anti-Idiotypic ; Antibodies, Monoclonal, Humanized ; Body Weight ; Histamine Antagonists ; Humans ; Immunoglobulin E ; Immunologic Factors ; Loratadine ; Prevalence ; Retrospective Studies ; Steroids ; Urticaria ; Omalizumab

Objective: To investigate the short-term efficacy of anti-IgE monoclonal antibody (Omalizumab) in the treatment of recurrent chronic rhinosinusitis with nasal polyps (CRSwNP) complicated with asthma. Methods: Patients with recurrent CRSwNP and comorbid asthma in Beijing TongRen Hospital from May to December of 2020 were continuously recruited and received a 4-month therapy of stable background treatment plus Omalizumab. Results of visual analog scales (VAS) of nasal symptoms, sino-nasal outcome test-22 (SNOT 22) and nasal polyp scores were collected at baseline and post-treatment (1, 2, 3 and 4 months after treatment). Blood routine tests, total nasal resistances (TNR), minimum cross-sectional areas (MCA), total nasal cavity volumes (NCV), forced expiratory volumes in one second (FEV1)/forced vital capacity (FVC) and adverse events were collected at baseline and 4 months after treatment. All results were evaluated for short-term efficacy of Omalizumab. GraphPad Prism 8.2.1 was used for statistic analysis. Results: Ten patients were collected, including 3 males and 7 females, aged (41.13±12.64) years old (x¯±s). Compared to results at baseline, the VAS scores of nasal obstruction, rhinorrhea, hyposmia and headache after 4 months treatment were significantly decreased (1.80±1.48 vs 6.70±2.83, 2.40±1.27 vs 6.40±3.44, 2.70±2.91 vs 8.20±2.25, 0.60±1.08 vs 3.60±2.72, t value was 5.045, 4.243, 5.312, 3.402, respectively, all P<0.01). The scores of SNOT-22 (25.6±20 vs 61.3±33.32, t=4.127, P=0.002 6), nasal polyp scores (2.20±0.92 vs 4.60±0.84, t=9.000, P<0.01) and the count and percentage of eosinophils in peripheral blood were significantly decreased ((94.10±97.78)×10⁹/L vs (360.00±210.80)×10⁹/L, (32.90±27.06)% vs (64.40±20.73)%, t value was 3.678, 2.957, respectively, all P<0.05). NCV (0-5 cm and 0-7 cm) of patients were improved from baseline ((12.62±2.84) cm³ vs (10.40±2.09) cm³, (27.50±14.15) cm³ vs (16.81±6.40) cm³, t value was 2.371, 2.445, respectively, all P<0.05). Conclusions: The 4-month treatment of Omalizumab can significantly improve the nasal symptoms and quality of life of patients with recurrent CRSwNP complicated with asthma, shrink nasal polyps size and reduce the number of peripheral blood eosinophils. Omalizumab can be used as an alternative therapy for refractory CRSwNP patients in the future.
Adult ; Antibodies, Anti-Idiotypic ; Asthma/drug therapy* ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps/drug therapy* ; Omalizumab/therapeutic use* ; Quality of Life ; Rhinitis/drug therapy*

Antibodies, Anti-Idiotypic ; therapeutic use ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Asthma ; drug therapy ; immunology ; Cytokines ; antagonists & inhibitors ; Humans ; Interleukin-5 ; antagonists & inhibitors ; Omalizumab ; Receptors, Interleukin-4 ; therapeutic use ; T-Lymphocytes ; physiology ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors

Chronic spontaneous urticaria is defined as persistent symptoms of urticaria for 6 weeks or more. It is associated with autoimmunity in approximately 45 percent of patients. Therapy is often difficult however the initial approach should employ high-dose non-sedating antihistamines; 4-6 tablets/day may be necessary. It has been shown that the response to 4 tablets/day exceeds 3, and exceeds 2, which exceeds 1. However the dose that corresponds to the maximal dose of first generation antihistamines (hydroxyzine, diphenhydramine) used previously, is 6/day. Yet over half the patients are refractory to antihistamines and other agents should be tried next. Whereas current guidelines (published) often add leukotriene antagonists and/or H2 receptor antogonists next, these are of little utility. Likewise drugs effective for urticarial vasculitis (colchicine, dapsone, sulfasalazine, hydroxychloroquine) are effective in a small percentage of patients and no study suggests that the response rate of any of them exceeds the 30% placebo responses seen in most double-blind, placebo controlled studies. The drugs that are effective for antihistamine-resistant chronic spontaneous urticaria are corticosteroids, cyclosporine, and Omalizumab. Use of steroids is limited by toxicity. If used at all, a dose of no more than 10 mg/day should be employed with a weekly reduction of 1 mg. The response rates to cyclosporine and Omalizumab are each close to 75%. Cyclosporine can be used effectively if care is taken to monitor blood pressure, urine protein, blood urea nitrogen, and creatinine, every 6 weeks. Omalizumab has the best profile in terms of efficacy/toxicity and, once approved by federal agencies for use in chronic spontaneous urticaria, a dramatic change in the treatment paradigm, whether associated with autoimmunity or not, is predicted. A phase 3 trial is currently in place. Refractoriness to both Omalizumab and cyclosporine is expected to be less than 5 percent of patients. Other agents, can then be tried.
Adrenal Cortex Hormones ; Antibodies, Anti-Idiotypic ; Antibodies, Monoclonal, Humanized ; Autoimmunity ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine ; Dapsone ; Histamine Antagonists ; Humans ; Hypogonadism ; Leukotriene Antagonists ; Mitochondrial Diseases ; Ophthalmoplegia ; Organothiophosphorus Compounds ; Steroids ; Sulfasalazine ; Urticaria ; Vasculitis ; Omalizumab

Atopic dermatitis is a chronic, relapsing, inflammatory skin disease, with genetic and environmental backgrounds. Successful management of atopic dermatitis requires a multipronged approach. Management should compromise of a disease-adapted treatment which combines adjuvant basic therapy, symptomatic relief and, if needed, anti-inflammatory treatment and the identification and avoidance of trigger factors. Topical calcineurin inhibitors are also considered to be good alternatives for the long-term control of severe atopic dermatitis. Also, new therapies such as immunomodulatory drugs, biologics, anti-IgE therapy, and CpG oligodeoxynucleotides (ODN) are considered to be effective in treatment of atopic dermatitis.
Antibodies, Anti-Idiotypic ; Biological Agents ; Calcineurin ; Dermatitis, Atopic ; Oligodeoxyribonucleotides ; Skin Diseases

Allergen inhalation challenge has been useful for examining the mechanisms of allergen-induced airway inflammation and the associated physiological changes and for documenting the efficacy of drugs to treat asthma. Allergen inhalation by a sensitized subject results in acute bronchoconstriction, beginning within 15-30 min and lasting 1-3 hr, which can be followed by the development of a late asthmatic response. Individuals who develop both an early and late response after allergen have more marked increases in airway hyperresponsiveness, and greater increases in allergen-induced airway inflammation, particularly in airway eosinophils and basophils. All of the currently available and effective treatments for asthma modify some aspects of allergen-induced responses. These medications include short-acting and long-acting inhaled beta2-agonists, inhaled corticosteroids, cromones, methylxanthines, leukotriene inhibitors, and anti-IgE monoclonal antibody. In addition, allergen inhalation challenge has become a useful method which can, in a very limited number of patients, provide key information on the therapeutic potential of new drugs being developed to treat asthma.
Adrenal Cortex Hormones ; Antibodies, Anti-Idiotypic ; Asthma ; Basophils ; Bronchoconstriction ; Eosinophils ; Humans ; Inflammation ; Inhalation