Anti-IgE Therapy for Asthma and Allergy (PDF)
pocketbook
(Sprache: Englisch)
Little new has been introduced into the armamentarium for asthma therapy in the last thirty years apart from improvements in b2-adrenoceptor agonists, corticosteroids and cysteinyl leukotriene antagonists. However, the introduction of a fully humanised...
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Little new has been introduced into the armamentarium for asthma therapy in the last thirty years apart from improvements in b2-adrenoceptor agonists, corticosteroids and cysteinyl leukotriene antagonists. However, the introduction of a fully humanised monoclonal antibody to immunoglobulin E (IgE) (omalizumab), should provide a new way of treating allergic disorders, with effects that extend beyond a single affected organ and tissue. The precise role of this new agent in treatment guidelines will need to be carefully evaluated, but its clear efficacy and safety provide a strong statement about the importance of IgE across the full spectrum of allergic disease. This pocketbook provides an illustrative summary of the role of IgE in the pathogenesis of asthma and allied allergic disorders, as well as the effects of anti-IgE therapy in the management of these conditions.
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2 What is immunoglobulin E? History of allergy
Allergic disorders have been described as far back as 3000BC, when King Menes, who ruled Egypt, was killed by a hornet. Greek scholars described the clinical symptoms of asthma, although this encompassed different types of breathing problem. In 1552, Dr Carden, a contemporary Italian physician, cured the Archbishop of St Andrew’s from asthma by getting rid of the feather quilt and pillows which he had used. In 1586, Marcello Donati of Germany described an aristocrat whose lips swelled whenever he indulged in eggs.
The first skin prick test under medical auspices seems to have been carried out by Pierre Borel in 1656. During the 17th century, German authors described weakness, fainting and asthma in certain subjects exposed to cats, mice, dogs and horses. Dr Bostock, who had symptoms of his eyes and chest, described hay fever, but the classic experiments of Charles Blackley, in 1873, provided the proof that hay fever was caused by grass pollen.
In 1839 the French physiologist Magendie described anaphylactic shock and death in dogs repeatedly injected with foreign proteins. Von Behring coined the term hypersensitivity to describe the exaggerated response and even death following a second dose of diphtheria toxin in animals. Portier and Richet first used the term anaphylaxis in 1902, when they described a clinical shock syndrome encountered in dogs given otherwise innocuous doses of toxin after a previous experience with the same substance.
The term allergy, meaning ‘changed reactivity’, was originally defined by Clemens von Priquet in 1906 as an altered capacity of the body to react to foreign substances. In the subsequent years, the mechanisms of anaphylactic reaction were further expanded by the experiments of Shultz and Dale on intestinal and uterine smooth muscles. Cellular involvement in the process of anaphylaxis was
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proposed; it was stated that the small amounts of antibody required were in fact affixed to the surface of appropriate target cells, and any subsequent interaction would result in cell damage and a consequent shock-like syndrome.
History of IgE
Allergy is often equated with the type I hypersensitivity reaction – an immediate hypersensitivity reaction mediated by IgE.This relationship between serum IgE and allergic diseases was recognized in the early 1900s when Otto Carl W. Prausnitz (1876–1963) and his colleague Heinz Küstner (1897–1963) identified ‘reagin’.They took serum from Küstner, who was allergic to fish, and injected it into the skin of Prausnitz.When the fish antigen was subsequently injected into the sensitized site, there was an immediate wheal and flare reaction.This reaction, called the P-K reaction, was the basis for the earliest bioassay for IgE activity.
History of IgE
Allergy is often equated with the type I hypersensitivity reaction – an immediate hypersensitivity reaction mediated by IgE.This relationship between serum IgE and allergic diseases was recognized in the early 1900s when Otto Carl W. Prausnitz (1876–1963) and his colleague Heinz Küstner (1897–1963) identified ‘reagin’.They took serum from Küstner, who was allergic to fish, and injected it into the skin of Prausnitz.When the fish antigen was subsequently injected into the sensitized site, there was an immediate wheal and flare reaction.This reaction, called the P-K reaction, was the basis for the earliest bioassay for IgE activity.
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Bibliographische Angaben
- Autoren: Stephen T Holgate , K Suresh Babu , S Hasan Arshad
- 2001, Englisch
- Verlag: Taylor & Francis Group Plc
- ISBN-10: 0203445902
- ISBN-13: 9780203445907
Abhängig von Bildschirmgröße und eingestellter Schriftgröße kann die Seitenzahl auf Ihrem Lesegerät variieren.
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