1、延時符Research Progress of Anti-IgE Antibody in the Treatment of Type I Hypersensitivity DiseasesContents1IgE and Type I Hypersensitivity2Anti-IgE Antibody3Omalizumab in Treating Asthma 4Omalizumb in Treating other diseases5Summary and Future Directions延時符1IgE & Type I HypersensitivityIgE & Type I Hype

2、rsensitivity延時符IgE AntibodySynthesised by plasma cells MonomersMediate immunity to parasitesPlay an essential role in Type I hypersensitibityDavid Male,etc, Immunology, 8th edition, Fig. 3.w3IgE & Type I Hypersensitivity延時符IgE ReceptorFcRIHigh affinityTetramers: 2Expressed on Mast cell and basophils

3、On APCs as trimers (2)FcRII (CD23)Low affinityExpressed on B-cells and other hematopoietic cellsDavid Male,etc, Immunology, 8th edition, Fig. 19IgE & Type I Hypersensitivity延時符David Male,etc, Immunology, 8th edition, Fig. 23.7Type I HypersensitivityFirst exposure to allergensIgE & Type I Hypersensit

4、ivity延時符David Male,etc, Immunology, 8th edition, Fig. 23.7Type I Hypersensitivity Second exposure to allergensDegranulation（Acute response） Late-Phase response成果應用Allergic athmaCommon Type I Hypersensitivity DiseasesPollen allergy Atopic dermatitisFood allergiesIgE & Type I Hypersensitivity2Anti-IgE

5、 Antibody延時符Anti-IgE AntibodyAnti-IgE Treatment Mediated by any form of biological medication targeting the synthesis or signalling pathway of IgE, either directly or indirectlyLumiliximabAnti-FcRII (CD23)LigelizumabAnti-IgEOmalizumbAnti-IgEMonoclonal antibody-12Anti-IgE延時符論文導讀延時符Anti-IgE AntibodyOm

6、alizumabMaxime Luu, etc, Pharmacokinetics, pharmacodynamics and clinical efficacy of omalizumab for the treatment of Asthma, Expert Opinion on Drug Metabolism & Toxicology,2016論文導讀延時符Anti-IgE AntibodyMechanism of OmalizumabMaxime Luu, etc, Pharmacokinetics, pharmacodynamics and clinical efficacy of

7、omalizumab for the treatment of Asthma, Expert Opinion on Drug Metabolism & Toxicology,2016論文導讀延時符Anti-IgE AntibodyThe mechanism of Omalizumab action on eosinophilic inflammation David Male,etc, Immunology, 8th edition, Fig. 3.w3Izabela Kupry-Lipiska, etc, The effect of omalizumab on eosinophilic in

8、flammationof the respiratory tract in patients with allergic asthma, Pneumonologia i Alergologia Polska, 20163Omalizumab in Treating Asthma 延時符Omalizumab in Treating Asthma 第二章Recurrent episodes of dyspnea, wheezing, chest tightness, and coughSymptomsReccurenceFamily historyProlonged course of disea

9、seRich in complicationsCharacteristics Asthma: a chronic inflammatory disease of the airways that can be life-threatening, caused by a combination of genetic and environmental factors.延時符United States-National Institute of Health: National Heart, Lung, Blood Institute ， /health/health-topics/topics/

10、asthma/論文導讀延時符Omalizumab in Treating Asthma Key features：Bronchospasm; Airflow obstruction; Airway remodelingMajor Pathological Changes in AsthmaKonstantinos Samitas, etc, Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives, Eu

11、r Respir Rev, 2015論文導讀延時符Omalizumab in Treating Asthma IgE participates in airway remodeling indirectlyDavid Male,etc, Immunology, 8th edition, Fig. 23.18論文導讀延時符Omalizumab in Treating Asthma IgE participates in airway remodeling directlyKonstantinos Samitas, etc, Anti-IgE treatment, airway inflammat

12、ion and remodelling in severe allergic asthma: current knowledge and future perspectives, Eur Respir Rev, 2015論文導讀延時符Omalizumab in Treating Asthma 論文導讀延時符Omalizumab in Treating Asthma 論文導讀延時符Omalizumab in Treating Asthma Normansell R, etc, Omalizumab for asthma in adults and children, Cochrane Datab

13、ase of Systematic Reviews 2014論文導讀延時符Omalizumab in Treating Asthma Effects of omalizumab in treating asthmaExacerbation decreases, especially for moderate to severe asthma patientsSteroid sparing effectsImprovement in asthma symptomsSignificant improvements in health-related quality of lifeRescue me

14、dication use decreasesVery modest improvements in lung functionPotential adverse effectsOmalizumab group v.s placebo group, less likely to experience a serious adverse eventInjection site reactionsimmune complex-mediated pathology and abnormal immune responses to parasitic infectionincreased risk of

15、 cancer論文導讀延時符Omalizumab in Treating Asthma Is omalizumab Cost-effective or not?Tianwen Lai,etc, Long-term efficacy and safety of omalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis, Scientific reports, 20154Omalizumb in Treating other diseases延

16、時符論文導讀延時符Omalizumb in Treating other diseases A short treatment course of omalizumab improves the safety and tolerability of peanut updosing during peanut oral immunotherapy（OIT）Andrew J. MacGinnitie, etc, Omalizumab facilitates rapid oral desensitization for peanut allergy, J ALLERGY CLIN IMMUNOL,

17、2016論文導讀延時符Omalizumb in Treating other diseasesNo concrete evidence of the overall effectiveness of omalizumab for atopic dermatitisHsiao-Han Wang, etc, Efficacy of omalizumab in patients with atopic dermatitis: A systematic review andmeta-analysis, J ALLERGY CLIN IMMUNOL, 2016論文導讀延時符Omalizumb in Tr

18、eating other diseasesCombination of omalizumab with SIT significantly reduced the symptom load comparedwith those on SIT alone in patients with seasonal allergic rhinitis (SAR) and comorbid seasonal allergic asthma (SAA)Matthias Volkmar Kopp，Transient impact of omalizumab in pollen allergic patients

19、undergoing specific immunotherapy, Pediatric Allergy and Immunology, 20135Summary and Future Directions延時符Summary1SummaryOmalizumab is the only anti-IgE antibody currently licensed for use in humans2As an add-on therapy, omalizumb has been proven very effective in uncontrolled allergic asthma3No ser

20、ious adverse effect of omalizumab has been observed except injection site reactions 4Omalizumab shows less convincing but real steroid-sparing effect延時符01020304Future directionOmalizumab in specific populationOptimal duration of treatment?Cost-efectiveness？Long-time efficacy and safety profilePredic

21、tors of a response to omalizumabOmalizumab in other allergic diseasesOther monoclonal antibodiesPractical questions to be answeredChronic spontaneous urticaria, atopic dermatitis, food allergy, etc Lumiliximab, Ligelizumab, mepolizumab, etcFuture directions論文導讀延時符References1Konstantinos Samitas, Vas

22、iliki Delimpoura, Eleftherios Zervas, et al. Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives, Eur Respir Rev 2015; 24: 594-6012Ching-Hsiung Lin, Shih-Lung Cheng, A review of omalizumab for the management of severe asthma, D

23、rug Design, Development and Therapy, 2016:10 236923783Michael C Saavedra, Sanjiv Sur, Down regulation of the high-affinity IgE receptor associated with successful treatment of chronic idiopathic urticaria with omalizumab, Saavedra and Sur Clinical and Molecular Allergy, 2011, 9:24 Tianwen Lai, Shaob

24、in Wang, Zhiwei Xu, et al, Long-term efficacy and safety ofomalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis, SCIENTIFIC REPORTS, 2015, 1-95 Caroline Sattlera, Gilles Garciaa, Marc Humbert, Novel targets of omalizumab in asthma, Wolters Kluwer

25、 Health, 20166 Normansell R, Walker S, Milan SJ, Omalizumab for asthma in adults and children (Review) The Cochrane Collaboration, 20147 Hsiao-Han Wang, etc, Efficacy of omalizumab in patients with atopic dermatitis: A systematic review andmeta-analysis, j allergy clin immunol, 2016, 1719-17228 Andrew J. MacGinnitie, MD, PhD, Rima Rachid, MD