Experience with monoclonal antibodies in allergic mediated disease: Seasonal allergic rhinitis

Current therapies for the treatment of seasonal allergic rhinitis include a llergen avoidance; pharmacologic interventions such as sympathomimetics, to pical and systemic corticosteroids, and chromones; and immunotherapy. In an attempt to create a novel therapy, therapeutic agents have been designed t o inhibit IgE responses that are intimately involved in the induction of th e allergic response. Omalizumab, a humanized monoclonal antibody against Ig E, represents a novel therapeutic intervention for seasonal allergic rhinit is. Complex formation of omalizumab with serum-free IgE reduces the amount of IgE available for binding to effector cells and thus has the potential t o reduce IgE-mediated allergic symptoms. Clinical trial results confirmed t hat omalizumab reduces free IgE to a level that is associated with suppress ed allergic symptoms. reduces concomitant rescue medication use, and improv es rhinitis-specific quality of lire. Patients treated with omalizumab duri ng one pollen season can be re-treated during the subsequent season with mi nimal risk of adverse events. Omalizumab is non-allergen-specific and does not induce acute anaphylaxis because of the lack or IgE crosslinking with b asophil- or mast-celt-bound IgE. Furthermore, subcutaneous or intravenous a dministration of omalizumab does not invoke the generation of anti-omalizum ab antibodies. Thus, omalizumab represents a novel agent that should assist in the treatment of allergic rhinitis.