Omalizumab
Omalizumab is a humanized IgG1/κ monoclonal antibody (mAb) that binds to
the Fc fragment of IgE122. This mAb inhibits
binding of IgE to the high-affinity IgE (FcεRI) receptor on human mast
cells and basophils123,
124. Several studies have documented
the efficacy of omalizumab in improving allergic asthma and reducing
symptoms and exacerbations125-127 also in
children and pregnant women128-130. Although
omalizumab did not cause FEV1 improvement in RCTs131,
132, there is some evidence that this
mAb can improve FEV1 in real-life settings133,
134 and can reduce the thickness of the
basement membrane 135,
136 and fibronectin deposits in
asthmatic airways 137in addition to preventing exacerbation-induced inflammatory alterations
in the airways. IgE-containing serum from asthmatic patients stimulatedin vitro mesenchymal cell proliferation and accumulation of
collagen and fibronectin. Both proliferation and matrix deposition were
prevented by preincubation of the cells with omalizumab109.