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Eosinophils in bronchial mucosa of asthmatics after allergen challenge: effect of anti-IgE treatment.
Allergy. 2009 Jan; 64(1):72-80.A

Abstract

BACKGROUND

Anti-IgE, omalizumab, inhibits the allergen response in patients with asthma. This has not been directly related to changes in inflammatory conditions. We hypothesized that anti-IgE exerts its effects by reducing airway inflammation. To that end, the effect of anti-IgE on allergen-induced inflammation in bronchial biopsies in 25 patients with asthma was investigated in a randomized, double-blind, placebo-controlled study.

METHODS

Allergen challenge followed by a bronchoscopy at 24 h was performed at baseline and after 12 weeks of treatment with anti-IgE or placebo. Provocative concentration that causes a 20% fall in forced expiratory volume in 1 s (PC(20)) methacholine and induced sputum was performed at baseline, 8 and 12 weeks of treatment. Changes in the early and late responses to allergen, PC(20), inflammatory cells in biopsies and sputum were assessed.

RESULTS

Both the early and late asthmatic responses were suppressed to 15.3% and 4.7% following anti-IgE treatment as compared with placebo (P < 0.002). This was paralleled by a decrease in eosinophil counts in sputum (4-0.5%) and postallergen biopsies (15-2 cells/0.1 mm(2)) (P < 0.03). Furthermore, biopsy IgE+ cells were significantly reduced between both the groups, whereas high-affinity IgE receptor and CD4+ cells were decreased within the anti-IgE group. There were no significant differences for PC(20) methacholine.

CONCLUSION

The response to inhaled allergen in asthma is diminished by anti-IgE, which in bronchial mucosa is paralleled by a reduction in eosinophils and a decline in IgE-bearing cells postallergen without changing PC(20) methacholine. This suggests that the benefits of anti-IgE in asthma may be explained by a decrease in eosinophilic inflammation and IgE-bearing cells.

Authors+Show Affiliations

Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19076931

Citation

van Rensen, E L J., et al. "Eosinophils in Bronchial Mucosa of Asthmatics After Allergen Challenge: Effect of anti-IgE Treatment." Allergy, vol. 64, no. 1, 2009, pp. 72-80.
van Rensen EL, Evertse CE, van Schadewijk WA, et al. Eosinophils in bronchial mucosa of asthmatics after allergen challenge: effect of anti-IgE treatment. Allergy. 2009;64(1):72-80.
van Rensen, E. L., Evertse, C. E., van Schadewijk, W. A., van Wijngaarden, S., Ayre, G., Mauad, T., Hiemstra, P. S., Sterk, P. J., & Rabe, K. F. (2009). Eosinophils in bronchial mucosa of asthmatics after allergen challenge: effect of anti-IgE treatment. Allergy, 64(1), 72-80. https://doi.org/10.1111/j.1398-9995.2008.01881.x
van Rensen EL, et al. Eosinophils in Bronchial Mucosa of Asthmatics After Allergen Challenge: Effect of anti-IgE Treatment. Allergy. 2009;64(1):72-80. PubMed PMID: 19076931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eosinophils in bronchial mucosa of asthmatics after allergen challenge: effect of anti-IgE treatment. AU - van Rensen,E L J, AU - Evertse,C E, AU - van Schadewijk,W A A M, AU - van Wijngaarden,S, AU - Ayre,G, AU - Mauad,T, AU - Hiemstra,P S, AU - Sterk,P J, AU - Rabe,K F, Y1 - 2008/12/12/ PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/2/28/medline SP - 72 EP - 80 JF - Allergy JO - Allergy VL - 64 IS - 1 N2 - BACKGROUND: Anti-IgE, omalizumab, inhibits the allergen response in patients with asthma. This has not been directly related to changes in inflammatory conditions. We hypothesized that anti-IgE exerts its effects by reducing airway inflammation. To that end, the effect of anti-IgE on allergen-induced inflammation in bronchial biopsies in 25 patients with asthma was investigated in a randomized, double-blind, placebo-controlled study. METHODS: Allergen challenge followed by a bronchoscopy at 24 h was performed at baseline and after 12 weeks of treatment with anti-IgE or placebo. Provocative concentration that causes a 20% fall in forced expiratory volume in 1 s (PC(20)) methacholine and induced sputum was performed at baseline, 8 and 12 weeks of treatment. Changes in the early and late responses to allergen, PC(20), inflammatory cells in biopsies and sputum were assessed. RESULTS: Both the early and late asthmatic responses were suppressed to 15.3% and 4.7% following anti-IgE treatment as compared with placebo (P < 0.002). This was paralleled by a decrease in eosinophil counts in sputum (4-0.5%) and postallergen biopsies (15-2 cells/0.1 mm(2)) (P < 0.03). Furthermore, biopsy IgE+ cells were significantly reduced between both the groups, whereas high-affinity IgE receptor and CD4+ cells were decreased within the anti-IgE group. There were no significant differences for PC(20) methacholine. CONCLUSION: The response to inhaled allergen in asthma is diminished by anti-IgE, which in bronchial mucosa is paralleled by a reduction in eosinophils and a decline in IgE-bearing cells postallergen without changing PC(20) methacholine. This suggests that the benefits of anti-IgE in asthma may be explained by a decrease in eosinophilic inflammation and IgE-bearing cells. SN - 1398-9995 UR - https://www.unboundmedicine.com/medline/citation/19076931/Eosinophils_in_bronchial_mucosa_of_asthmatics_after_allergen_challenge:_effect_of_anti_IgE_treatment_ L2 - https://doi.org/10.1111/j.1398-9995.2008.01881.x DB - PRIME DP - Unbound Medicine ER -