Monatsschrift Kinderheilkunde

, Volume 155, Issue 2, pp 134–137

Anti-IgE-Therapie bei Kindern und Jugendlichen

Leitthema
  • 45 Downloads

Zusammenfassung

Immunglobulin E (IgE) besitzt eine Schlüsselrolle als Vermittler allergischer Reaktionen gegenüber Nahrungsmittel- oder Umweltallergenen, die bei der klinischen Ausprägung allergischer Symptome der Atemwege (allergische Rhinokonjunktivitis, Asthma bronchiale), der Haut (Urtikaria, atopische Dermatitis) und des Magen-Darm-Trakts (Nahrungsmittelallergien) von besonderer Bedeutung sind. Der rekombinante, humanisierte Antikörper Omalizumab, der seit 2005 in Deutschland für die Behandlung des schweren allergischen Asthma bronchiale für Kinder ab 12 Jahren zur Verfügung steht, hat für besondere Problemfälle seine therapeutische Wirksamkeit und – nach derzeitiger Datenlage – auch bei jüngeren Kindern seine gute Verträglichkeit belegt. Anti-IgE bietet über das Asthma bronchiale hinaus interessante Perspektiven für bisher schwer behandelbare, komplexe allergische Krankheitsbilder mit hohem Leidensdruck.

Schlüsselwörter

Immunglobulin E Asthma bronchiale Komplexe Allergie Omalizumab Anti-IgE 

Anti-IgE therapy for children and adolescents

Abstract

Immunoglobulin E (IgE) plays a key role in mediating allergic reactions to food and environmental allergens, which are relevant for the expression of allergic symptoms of the airways (rhinoconjunctivitis, bronchial asthma), the skin (urticaria, atopic dermatitis), as well as the gastrointestinal tract (food allergens). The recombinant humanized antibody omalizumab, which became available in Germany in 2005 for the treatment of severe allergic asthma for children aged 12 years and above, has proved its therapeutic efficacy for special cases,as well as its safety in all age groups. In addition to bronchial asthma, anti-IgE offers interesting perspectives for the treatment of complex allergic diseases which have a strong impact on quality of life and have so far been difficult to control.

Keywords

IgE Bronchial asthma Complex allergies Omalizumab Anti-IgE 

Literatur

  1. 1.
    Beck LA, Marcotte GV, MacGlashan D et al. (2004) Omalizumab-induced reductions in mast cell Fcε expression and function. J Allergy Clin Immunol 114: 527–530CrossRefPubMedGoogle Scholar
  2. 2.
    Bousquet J, Cauwenberge J, Cabrera P et al. (2005) The effect of treatment with omalizumab, an anti-IgE antibody, on asthma exacerbation and emergency medical visits in patients with severe persistent asthma. Allergy 60: 302–308CrossRefPubMedGoogle Scholar
  3. 3.
    Buhl R, Hanf G, Soler M et al. (2002) The anti-IgE antibody omalizumab improves asthma-related quality of life in patients with allergic asthma. Eur Respir J 20: 1088–1094CrossRefPubMedGoogle Scholar
  4. 4.
    Buhl R, Solèr M, Matz J et al. (2002) Omalizumab provides a long-term control in patients with moderate-to-severe allergic asthma. Eur Respir J 20: 73–78CrossRefPubMedGoogle Scholar
  5. 5.
    Casale TB, Condemi J, LaForce C et al. (2001) Effect of omalizumab on symptoms of seasonal allergic rhinitis. JAMA 286: 2956–2967CrossRefPubMedGoogle Scholar
  6. 6.
    Chang TW, Shiung YY (2006) Anti-IgE as a mast cell-stabilizing therapeutic agent. Rev J Allergy Clin Immunol 117: 1203–1212CrossRefGoogle Scholar
  7. 7.
    Djukanovic R, Wilson SJ, Kraft M et al. (2004) Effects of treatment with anti-immunoglobulin E antibody omalizumab on airway inflammation in allergic asthma. Am J Respir Crit Care Med 170: 583–593CrossRefPubMedGoogle Scholar
  8. 8.
    Fahy JV, Fleming HE, Wong HH et al. (1997) The effect on an anti-IgE monoclonal antibody on the early- and late-phase responses to allergen inhalation in asthmatic subjects. Am J Respir Crit Care Med 155: 1828–1834PubMedGoogle Scholar
  9. 9.
    Hamelmann E, Rolinck-Werninghaus C, Wahn U (2002) From IgE to anti-IgE: where do we stand? Allergy 57: 983–994CrossRefPubMedGoogle Scholar
  10. 10.
    Hamelmann E, Rolinck-Werninghaus C, Wahn U (2003) Is there a role for anti-IgE in combination with specific allergen immunotherapy? Curr Opin Allergy Clin Immunol 3: 501–510CrossRefPubMedGoogle Scholar
  11. 11.
    Humbert M, Beasley R, Ayres J et al. (2005) Benefits of Omalizumab as add-on-therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE. Allergy 60: 309–316CrossRefPubMedGoogle Scholar
  12. 12.
    Kopp MV, Brauburger J, Riedinger F et al. (2002) The effect of anti-IgE-treatment on the in-vitro leukotriene release in children with seasonal allergic rhinitis. J Allergy Clin Immunol 110: 728–735CrossRefPubMedGoogle Scholar
  13. 13.
    Kuehr J, Brauburger J, Zielen S et al. (2002) Efficacy of combination treatment with anti-IgE plus specific immunotherapy in polysensitized children and adolescent with seasonal allergic rhinitis. J Allergy Clin Immunol 109: 274–280CrossRefPubMedGoogle Scholar
  14. 14.
    Leung DYM, Sampson HA, Yunginger JW et al. (2003) Effect of anti-IgE therapy in patients with peanut allergy. N Engl J Med 348: 986–993CrossRefPubMedGoogle Scholar
  15. 15.
    MacGlashan D Jr, McKenzie-White J, Chichester K et al. (1998) In vitro regulation of Fcε expression on human basophils by IgE antibody. Blood 91: 1633–1643PubMedGoogle Scholar
  16. 16.
    Milgrom H, Berger W, Nayak A et al. (2001) Treatment of childhood asthma with anti-immunoglobulin E antibody (omalizumab). Pediatrics 108: E36CrossRefPubMedGoogle Scholar
  17. 17.
    Poole JA, Mantakasombut P, Rosenwasser LJ (2005) Targeting the IgE molecule in allergic and asthmatic diseases: review of the IgE molecule and clinical efficacy. J Allergy Clin Immunol 114: 375–385CrossRefGoogle Scholar
  18. 18.
    Rolinck-Werninghaus C, Hamelmann E, Keil T et al. (2004) The Omalizumab Rhinitis Study Group. The co-seasonal application of anti-IgE after preseasonal specific immunotherapy decreases ocular and nasal symptom scores and rescue medication use in grass pollen allergic children. Allergy 59: 973–979CrossRefPubMedGoogle Scholar
  19. 19.
    Rolinck-Werninghaus E, Wahn U, Hamelmann E (2005) Anti-IgE therapy in allergic asthma. Curr Drug Targets Inflamm Allergy 4: 551–564CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Klinik für Pädiatrie mit Schwerpunkt Pneumologie und ImmunologieCharité-Universitätsmedizin Berlin, Campus Virchow-KlinikumBerlinDeutschland

Personalised recommendations