Researchers believe they’ve developed a way of disabling the process that triggers symptoms in patients with allergic asthma. If so, some allergic asthmatics may find relief of symptoms and possibly be able to reduce their need for corticosteroids, currently the mainstay of treatment for many asthmatics.

In order to understand the role of IgE (immunoglobulin E) in allergic asthma, it might be helpful to picture a string of dominoes. Think of an allergen (pollen, pet dander, cigarette smoke, etc.) as the first domino. For those with allergic asthma, exposure to an allergen tips that first domino, initiating a chain of events that results in respiratory distress. In this scenario, IgE would be the second domino after inhaling an allergen, because the person with allergic asthma produces specific antibodies for each allergen. These IgE antibodies bind with mast cells and basophils, triggering the airway inflammation associated with asthma.

Researchers believe if they can stop this process, symptoms of allergic asthma will be reduced. A recent study conducted by researchers from the National Jewish Medical and Research Center in Denver, Colorado, tested this theory with encouraging results. They used a treatment known as recombinant humanized monoclonal antibody (rhuMAb-E25) that binds to IgE, preventing it from interacting with mast cells and basophils.

These researchers studied 317 patients with allergic asthma severe enough to require inhaled or oral corticosteroids (or both). Patients were given either high- or low-dose rhuMAb-E25 intravenously or a placebo for the duration of the study, with doses being given at the beginning of the study, on days four and seven, and then once every two weeks for 20 weeks. Patients continued with their usual corticosteroid regimen for the first 12 weeks of the study, tapering and attempting to discontinue them during the last eight weeks of the study.

Patients receiving the rhuMAb-E25 had less severe asthma symptoms at 12 and 20 weeks, and more patients receiving it were able to decrease or discontinue corticosteroids than in the placebo group. These researchers believe that rhuMAb-E25 is a promising new approach to the treatment of allergic asthma.

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