Abstract
Asthma is a complex genetic disorder that is characterized by airway inflammation and reversible airflow obstruction. Severe asthmatics are inadequately controlled despite the use of high-dose inhaled corticosteroids (ICS) and long-acting B2-agonists. Role of IgE mediated inflammation in asthma is esthablished. Allergic inflammatory process underlies the pathogenesis of severe persistent asthma. The most widely used and currently only approved monoclonal antibody against IgE for use in asthma is Omalizumab. The efficacy and safety of omalizumab have been evaluated in several studies which showed a significant drop in asthma exacerbations, and emergency visits. The thickening of subepitelial basement membrane in severe asthmatic is associated to increased bronchial mucosal eosinophils, tipical allergic cellular effectors.
The aim of the study is to investigate the effect of anti-IgE on the basement membrane thickness. Biopsies were obtained from 11 patients with Severe Persistent Allergic Asthma. Before e post (12 months) treatment with omalizumab. RBM thickness was measured by morphometric anaysis by using light microscope image analysis. The analisys proved a significantly statistical difference, p<0.005, in a narrow population. Nonetheless we explored more in detail the entire population discriminating Responder and Non Responder on the basis of the obtained reduction in RBM thickness and different cut-off. The difference between Responder and Non-Responders proved statistically significant. Present data showed that 9/11 patients reduced the original RBM after treatment with anti-IgE, thus emphasizing the role of omalizumab in affecting asthma remodeling.
- © 2011 ERS
