Omalizumab in Ige-Mediated Food Allergy: A Systematic Review and Meta-Analysis

Zuberbier, Torsten; Wood, Robert A.; Bindslev-Jensen, Carsten; Fiocchi, Alessandro; Chinthrajah, Sharon; Worm, Margitta; Deschildre, Antoine; Fernandez-Rivas, Montserrat; Santos, Alexandra F.; Jaumont, Xavier; Tassinari, Paolo

doi:10.2139/ssrn.4117368

Cited by 2 publications

(1 citation statement)

References 45 publications

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“…However, given the presumptive role of IgE in mediating reactions to alpha-gal, omalizumab could be protective for AGS patients. 150 In addition, dupilumab, which targets the IL-4Rα, has been shown to strikingly decrease food-specific IgE levels. 151 Formal studies, ideally involving placebo-controlled trials, will be important to determine the relevance of biologics to AGS management.…”

Section: Iag Nos Is and Manag Ementmentioning

confidence: 99%

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Wilson,

Erickson,

Levin

et al. 2024

Allergy

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The recent recognition of a syndrome of tick‐acquired mammalian meat allergy has transformed the previously held view that mammalian meat is an uncommon allergen. The syndrome, mediated by IgE antibodies against the oligosaccharide galactose‐alpha‐1,3‐galactose (alpha‐gal), can also involve reactions to visceral organs, dairy, gelatin and other products, including medications sourced from non‐primate mammals. Thus, fittingly, this allergic disorder is now called the alpha‐gal syndrome (AGS). The syndrome is strikingly regional, reflecting the important role of tick bites in sensitization, and is more common in demographic groups at risk of tick exposure. Reactions in AGS are delayed, often by 2–6 h after ingestion of mammalian meat. In addition to classic allergic symptomatology such as urticaria and anaphylaxis, AGS is increasingly recognized as a cause of isolated gastrointestinal morbidity and alpha‐gal sensitization has also been linked with cardiovascular disease. The unusual link with tick bites may be explained by the fact that allergic cells and mediators are mobilized to the site of tick bites and play a role in resistance against ticks and tick‐borne infections. IgE directed to alpha‐gal is likely an incidental consequence of what is otherwise an adaptive immune strategy for host defense against endo‐ and ectoparasites, including ticks.

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Section: Iag Nos Is and Manag Ementmentioning

confidence: 99%

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Wilson,

Erickson,

Levin

et al. 2024

Allergy

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Biologic drugs and allergen immunotherapy: potential allies

Carlucci,

Spataro,

Daddato

et al. 2023

Explor Asthma Allergy

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Allergen-specific immunotherapy (AIT) is a proven efficacy treatment for allergic rhinitis (AR), asthma, and Hymenoptera venom allergy, but its use in food allergy (FA) is still under investigation. Because some efficacy and safety concerns still remain, biologic drugs, including omalizumab and dupilumab, have been studied as an adjunctive therapy to AIT for these conditions. In this article, the evidence supporting the use of monoclonal antibodies (mAbs) as an add-on therapy to AIT for FA, AR, asthma, and Hymenoptera venom allergy has been reviewed. The review will delve into the mechanisms of action of different mAbs, their efficacy, and how they can be integrated into personalized medicine approaches to treat allergic diseases. Furthermore, future research areas will be considered. Evidence suggests that omalizumab in combination with AIT may be a beneficial option for respiratory allergies or food desensitisation, especially during the escalation or build-up phase, when adverse events are more frequent. Currently, there is a small number of well-structured clinical trials in Hymenoptera venom allergy, and the available data consist mainly of single-case reports that provide information of limited value. Dupilumab has been studied as adjunctive therapy in patients with respiratory and FAs. Clinical trials are ongoing to evaluate the efficacy of dupilumab as monotherapy or as an adjunct to oral immunotherapy (OIT) in peanut allergy. Other studies are investigating the use of dupilumab in patients with multiple FAs and as an adjunct to milk OIT. Overall, mAbs have the potential to improve outcomes in various allergic conditions when used as an add-on to AIT, especially during the build-up phase. Further research is needed to fully understand their optimal dosing and duration of treatment, as well as to identify which patients may benefit the most from these therapies.

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Omalizumab in Ige-Mediated Food Allergy: A Systematic Review and Meta-Analysis

Cited by 2 publications

References 45 publications

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Biologic drugs and allergen immunotherapy: potential allies

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