PT  - JOURNAL ARTICLE
AU  - Marisa Hübner
AU  - Stephanie Korn
AU  - Matthias Jung
AU  - Ina Haasler
AU  - Christian Taube
AU  - Roland Buhl
TI  - Effects of omalizumab on markers of eosinophilic inflammation in patients with severe allergic asthma
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3352
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3352.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3352.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Allergic asthma is a chronic inflammatory airway disease in which immunoglobulin E (IgE) and eosinophils play important pathogenetic roles.We investigated the effect of the anti-IgE antibody omalizumab on markers of eosinophilic inflammation in patients with severe allergic asthma eligible for omalizumab treatment according to current guidelines. In 31 consecutive GINA step 4/5 patients (19 female, 48±11 yrs., 78±12 kg, 274±238 IU/ml total IgE, FEV1 at baseline 1.8±0.6 L, 61.8±19.5% pred.) omalizumab (median 450 mg/month) was administered s.c. as add-on therapy. Exhaled nitric oxide (NO), peripheral blood eosinophils and serum interleukin-5 were measured before and after 16 weeks of treatment. In all patients total daily doses of inhaled and oral corticosteroids remained stable during treatment.23 (74%) patients responded to therapy (GETE). Baseline NO was 43±8 ppb (mean±SEM) for responders (R) and 23±6 ppb for non-responders (NR), blood eosinophils were 0.38±0.07/nl (R) and 0.25±0.06/nl (NR), and IL-5 was 7.5±1.13 (R) and 1.9±1.3 pg/ml (NR, R vs. NR p=0.030). After 16 weeks NO decreased by 3±6 ppb (R, p=0.804) and 12±18 ppb (NR, p=0.375), blood eosinophils were unchanged (R week0-week16: -0.14±0.16/nl, p=0.687; NR: 0.01±0.04/nl, p=1.000), and IL-5 decreased by 3.7±1.0 pg/ml (R, p=0.012) and 0.3±1.4 pg/ml (NR, p=0.625).In conclusion, patients with a clinical response to omalizumab had higher pre-treatment serum IL-5 levels and a pronounced decrease in serum IL-5 following omalizumab. Blood eosinophils were unchanged, and exhaled NO was low prior and on treatment with omalizumab, consequent to high-dose ICS treatment.