Efficacy of omalizumab in the treatment of atopic dermatitis: A pilot study

Atopic dermatitis (AD) is a chronic inflammatory skin disease with specific immune and inflammatory mechanisms. Atopy is among the major features of the diagnosis criteria for AD but is not an essential feature. Thus, patients diagnosed with AD can be atopic or non-atopic. This review focuses on the role of IgE, mast cells, and eosinophils in the pathogenesis of AD. The known functions of IgE in allergic inflammation suggest that IgE and IgE-mediated mast cell and eosinophil activation contribute to AD, but direct evidence supporting this is scarce. The level of IgE (thus the degree of allergic sensitization) is associated with severity of AD and contributed by abnormality of skin barrier, a key feature of AD. The function of IgE in development of AD is supported by the beneficial effect of anti-IgE therapy in a number of clinical studies. The role of mast cells in AD is suggested by the increase in the mast cell number and mast cell activation in AD lesions and the association between mast cell activation and AD. It is further suggested by their role in mouse models of AD as well as by the effect of therapeutic agents for AD that can affect mast cells. The role of eosinophils in AD is suggested by the presence of eosinophilia in AD patients and eosinophil infiltrates in AD lesions. It is further supported by information that links AD to cytokines and chemokines associated with production, recruitment, and activation of eosinophils.

show abstract

“…The AD severity was assessed at 0, 1, 3, 6, and 9 months, and all the patients showed significant improvement [56].…”

Section: Effect Of Anti-ige Therapy On Admentioning

confidence: 99%

IgE, Mast Cells, and Eosinophils in Atopic Dermatitis

Liu

Goodarzi

Chen

2011

Clinic Rev Allerg Immunol

395

307

View full text Add to dashboard Cite

show abstract

“…Omalizumab is a humanized antibody that inhibits IgE binding to FcεRI, which is successfully used in severe asthma [32]. Surprisingly, the efficacy of omalizumab against atopic dermatitis remains contradictory as some clinical studies demonstrated that it was effective while others did not [33][34][35][36]. This might be due to different IgE levels in these patients in comparison to those who were treated for asthma.…”

Section: Inhibition Of Ige Bindingmentioning

confidence: 85%

Therapeutic Perspectives in Atopic Dermatitis

Miséry

2010

Clinic Rev Allerg Immunol

View full text Add to dashboard Cite

Therapy of atopic dermatitis should comprise emollients, topical glucocorticosteroids, or calcineurin inhibitors, phototherapies, immunosuppressants like cyclosporin A, and other treatments. All these treatments should be improved, thanks to research. But new therapeutic perspectives should be given by topical anti-inflammatory substances, selective glucocorticoid receptor agonists, probiotics, interferon γ, TNFα inhibitors, inhibition of T cells or B cells, inhibition of IgE binding, and many other possibilities.

show abstract

“…Upon low-dose antiIgE therapy with 10 cycles of 150 mg omalizumab, six of 11 AD patients with serum IgE levels >1000 kU/l before therapy responded as shown by a decrease in SCORAD by more than 50% in 2 and between 25 and 50% in four patients (83). Several studies reported that accompanying AD significantly improved in patients receiving omalizumab because of severe bronchial asthma (84)(85)(86). Nevertheless, the reports on the effects of omalizumab in AD are still controversial.…”

Section: Targeting B Cells and Igementioning

confidence: 99%