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Targeted therapy in severe asthma today: focus on immunoglobulin E

Asthma is a complex chronic inflammatory disease of multifactorial etiology. International guidelines increasingly recognize that a standard “one size fits all” approach is no longer an effective approach to achieve optimal treatment outcomes, and a number of disease phenotypes have been proposed fo...

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Autores principales: Pelaia, Girolamo, Canonica, Giorgio Walter, Matucci, Andrea, Paolini, Rossella, Triggiani, Massimo, Paggiaro, Pierluigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500555/
https://www.ncbi.nlm.nih.gov/pubmed/28721017
http://dx.doi.org/10.2147/DDDT.S130743
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author Pelaia, Girolamo
Canonica, Giorgio Walter
Matucci, Andrea
Paolini, Rossella
Triggiani, Massimo
Paggiaro, Pierluigi
author_facet Pelaia, Girolamo
Canonica, Giorgio Walter
Matucci, Andrea
Paolini, Rossella
Triggiani, Massimo
Paggiaro, Pierluigi
author_sort Pelaia, Girolamo
collection PubMed
description Asthma is a complex chronic inflammatory disease of multifactorial etiology. International guidelines increasingly recognize that a standard “one size fits all” approach is no longer an effective approach to achieve optimal treatment outcomes, and a number of disease phenotypes have been proposed for asthma, which has the potential to guide treatment decisions. Among the many asthma phenotypes, allergic asthma represents the widest and most easily recognized asthma phenotype, present in up to two-thirds of adults with asthma. Immunoglobulin E (IgE) production is the primary and key cause of allergic asthma leading to persistent symptoms, exacerbations and a poor quality of life. Therefore, limiting IgE activity upstream could stop the entire allergic inflammation cascade in IgE-mediated allergic asthma. The anti-IgE treatment omalizumab has an accepted place in the management of severe asthma (Global Initiative for Asthma [GINA] step 5) and represents the first (and, currently, only) targeted therapy with a specific target in severe allergic asthma. This review summarizes current knowledge of the mechanisms and pathogenesis of severe asthma, examines the actual role of IgE in asthma and the biological rationale for targeting IgE in allergic asthma and reviews the data for the efficacy and safety of omalizumab in the treatment of severe asthma. Current knowledge of the role of IgE in asthma, extensive clinical trial data and a decade of use in clinical practice has established omalizumab as a safe and effective targeted therapy for the treatment of patients with severe persistent IgE-mediated allergic asthma.
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spelling pubmed-55005552017-07-18 Targeted therapy in severe asthma today: focus on immunoglobulin E Pelaia, Girolamo Canonica, Giorgio Walter Matucci, Andrea Paolini, Rossella Triggiani, Massimo Paggiaro, Pierluigi Drug Des Devel Ther Review Asthma is a complex chronic inflammatory disease of multifactorial etiology. International guidelines increasingly recognize that a standard “one size fits all” approach is no longer an effective approach to achieve optimal treatment outcomes, and a number of disease phenotypes have been proposed for asthma, which has the potential to guide treatment decisions. Among the many asthma phenotypes, allergic asthma represents the widest and most easily recognized asthma phenotype, present in up to two-thirds of adults with asthma. Immunoglobulin E (IgE) production is the primary and key cause of allergic asthma leading to persistent symptoms, exacerbations and a poor quality of life. Therefore, limiting IgE activity upstream could stop the entire allergic inflammation cascade in IgE-mediated allergic asthma. The anti-IgE treatment omalizumab has an accepted place in the management of severe asthma (Global Initiative for Asthma [GINA] step 5) and represents the first (and, currently, only) targeted therapy with a specific target in severe allergic asthma. This review summarizes current knowledge of the mechanisms and pathogenesis of severe asthma, examines the actual role of IgE in asthma and the biological rationale for targeting IgE in allergic asthma and reviews the data for the efficacy and safety of omalizumab in the treatment of severe asthma. Current knowledge of the role of IgE in asthma, extensive clinical trial data and a decade of use in clinical practice has established omalizumab as a safe and effective targeted therapy for the treatment of patients with severe persistent IgE-mediated allergic asthma. Dove Medical Press 2017-06-29 /pmc/articles/PMC5500555/ /pubmed/28721017 http://dx.doi.org/10.2147/DDDT.S130743 Text en © 2017 Pelaia et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Pelaia, Girolamo
Canonica, Giorgio Walter
Matucci, Andrea
Paolini, Rossella
Triggiani, Massimo
Paggiaro, Pierluigi
Targeted therapy in severe asthma today: focus on immunoglobulin E
title Targeted therapy in severe asthma today: focus on immunoglobulin E
title_full Targeted therapy in severe asthma today: focus on immunoglobulin E
title_fullStr Targeted therapy in severe asthma today: focus on immunoglobulin E
title_full_unstemmed Targeted therapy in severe asthma today: focus on immunoglobulin E
title_short Targeted therapy in severe asthma today: focus on immunoglobulin E
title_sort targeted therapy in severe asthma today: focus on immunoglobulin e
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500555/
https://www.ncbi.nlm.nih.gov/pubmed/28721017
http://dx.doi.org/10.2147/DDDT.S130743
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