Severe bronchial asthma: possibilities of biological anti-IgE therapy


DOI: https://dx.doi.org/10.18565/therapy.2020.2.69-81

Nenasheva N.M.

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia, Moscow
The article is devoted to characteristic of severe and difficult to control bronchial asthma (BA), its differences from uncontrolled BA. Particular attention is paid to the algorithm of identifying patients with severe asthma, their characteristics and phenotypes. A modern understanding of eosinophilic T2 asthma conception is represented. The main emphasis is made on allergic severe BA (SBA) as the most common phenotype of the disease. The key role of immunoglobulin E (IgE) in the pathogenesis of allergic asthma and the possibility of anti-IgE therapy with omalizumab are discussed. The results of studies on the participation of IgE in respiratory tract remodeling and the possibility of influencing this process using omalizumab therapy are presented here.
They show that omalizumab can have a modifying effect on the components of the respiratory tract remodeling in case of severe allergic BA, which in turn lets to suggest a disease-modifying effect of omalizumab. The results of omalizumab long-term clinical efficacy and safety in cases from moderate to severe allergic bronchial asthma are also represented.
Keywords: bronchial remodeling, immunoglobulin E, allergic severe asthma, T2-asthma, phenotypes and endotypes of asthma, severe bronchial asthma, omalizumab
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About the Autors

Natalya M. Nenasheva, MD, professor, head of the Department of allergology and immunology of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 125993, Moscow, 2/1 build 1 Barrikadnaya Str. Tel.: +7 (495) 685-13-95. Email: 1444031@gmail.com. ORCID: 0000-0002-3162-2510

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