IgE regulation and roles in asthma pathogenesis

Asthma and the predisposition to produce IgE are inherited as linked traits in families. In patients IgE levels correlate with asthma severity and bro nchial hyperresponsiveness. The concept that IgE plays a critical role in a sthma pathogenesis has driven the development of IgE blockers, which are cu rrently being introduced into clinical use. This review focuses on the mech anisms whereby IgE participates both in immediate hypersensitivity response s in the airways and in the induction of chronic allergic bronchial inflamm ation. The molecular genetic events that give rise to IgE production by B c ells and the cellular and cytokine factors that support IgE production in t he bronchial mucosal microenvironment are discussed. It is clear that much remains to be learned regarding the roles of IgE in asthma and the genetic and environmental influences that lead to its production. Over the next few years, the emerging experience with anti-IgE in patients mill provide a mo re complete understanding of the mechanisms whereby IgE contributes to dise ase, as well as the therapeutic potential of its inhibition.