Abstract
Current therapies for seasonal allergic rhinitis include
allergen avoidance, pharmacologic interventions such
as antihistamines, sympathomimetics, topical and systemic
corticosteroids, and chromones and immunotherapy.
Although
pharmacologic agents are effective for some patients,
their role is limited by their inability to completely
relieve symptoms, and in some cases, the induction
of deleterious side effects. Immunotherapy (IT) regimens
can be highly effective in controlling symptoms of
SAR and can offer advantages over pharmacotherapy
for those
patients who have symptoms that are refractory to medications
or those who cannot tolerate the side effects. However,
traditional IT is associated with the risk of allergic
reactions to the extract injections and its effectiveness
for allergic respiratory disorders is not always
evident.
Allergic diseases are mediated by IgE and Th2-type
immune responses, which are opposed by Th1-like responses.
Omalizumab (anti-IgE) reduces IgE levels thereby leading
to decreased FcER1 and CD23 expression on key immune
effector cells. These and other changes evoked by omalizumab
cause a blunting of allergic respiratory symptoms.
In
a recent clinical trial, the combination of omalizumab
+ immunotherapy (IT) produced a greater reduction
in
symptoms than IT alone. However, the omalizumab was
added to existing IT. This study will examine omalizumab
as a pretreatment to IT to condition the recipient
in an attempt to suppress Th2-like responses.
Specifically, this study will:
- examine whether anti-IgE (omalizumab) given 9 weeks
prior to rush IT (RIT) followed by 12 weeks of dual
anti-IgE + IT is safer and more effective than anti-IgE
alone, RIT alone or placebo in preventing the symptoms
of ragweed-induced SAR;
- study the immunologic mechanisms of action associated
with these therapies; and
- study whether there is induction of tolerance after
discontinuing these therapies as manifested by persistent
inhibition of in vivo challenges and prolonged in
vitro immunologic changes indicative of immune tolerance.
Manuscripts
Casale TB, Busse WW, Kline JN, Ballas ZK, Moss MH, Townley RG, Mokhtarani M, Seyfert-Margolis V, Asare A, Bateman K, Deniz Y, Immune Tolerance Network. Omalizumab Pretreatment Decreases Acute Reactions Following Rush Immunotherapy for Ragweed-Induced Seasonal Allergic Rhinitis. J Allergy Clin Immunol 117: 134-140, 2006.
[PubMed]
[Reprint]
Klunker S, Saggar LR, Seyfert-Margolis V, Asare AL, Casale TB, Durham SR, Francis JN; Immune Tolerance Network Group. Combination treatment with omalizumab and rush immunotherapy for ragweed-induced allergic rhinitis: Inhibition of IgE-facilitated allergen binding. J Allergy Clin Immunol 120: 688-95, 2007.
[PubMed]
[Reprint]
Meeting Abstracts
Seyfert VL, Asare AL, Bourcier K, Wang R, Gao Z, Casale TB.
Transcriptome Seasonal Regulation in Ragweed Allergy.
2007 AAAAI Annual Meeting,
San Diego, CA, Feb 23-27, 2007.
[Abstract]
Scheuermann RH, Qian Y, Kong M, Casale TB, Campbell J, Sadat E, Thomson E, Dunn P, Xiang D, Dahlke CE.
Automated analysis of flow cytometry data for the identification of cellular markers of allergy therapeutic responses.
(Abstract #(J. Immunol., Apr 2010; 184: 91.2))
Immunology 2010 (97th Annual Meeting of the American Association of Immunologists),
Baltimore, MD, May 13-17, 2010.
[Abstract]
Francis JN, Saggar LR, Seyfert-Margolis V, Asare AL, Klunker S, Casale TB, Durham SR and Immune Tolerance Network Group.
The combination of anti-IgE monoclonal antibody (omalizumab) with ragweed immunotherapy results in enhanced and long-term inhibitory effects on facilitated-antigen presentation.
XXVI Meeting of the EAACI,
Goteborg, Sweden, June 9-13, 2007.
[Abstract]
Casale TB.
Anti-IgE monoclonal antibody administered with immunotherapy (Stanislaus Jaros Lecture).
American College of Allergy, Asthma and Immunology (ACAAI),
Boston, MA, Nov 4-9, 2004.
[Abstract]
Casale TB, Kline JN, Busse WW, Ballas ZK, Mokhtarani M, Seyfert-Margolis V, Bateman K, Moss MH, Townley RG.
Omalizumab pretreatment prevents allergic reactions due to rush immunotherapy (RIT).
(Abstract #259)
AAAAI Annual Meeting,
San Antonio, TX, March 18-22, 2005.
[Abstract]
Klunker S, Francis JN, Casale TB, Durham SR.
Anti-IgE Therapy Inhibits IgE-facilitated Allergen Presentation and Increases the Efficacy of Ragweed Immunotherapy.
2006 AAAAI Annual Meeting,
Miami, FL, March 3-7, 2006.
[Abstract]
Casale TB.
Omalizumab And Immunotherapy.
American College of Allergy, Asthma and Immunology (ACAAI),
Boston, MA, Nov 4-9, 2004.
[Abstract]
Kline JN, Casale TB, Busse WW, Ballas ZK,Mokhtarani M, Bromstead C, Seyfert-
Margolis V, Asare A, Bateman K, Moss MH, Townley RG.
Omalizumab Plus Rush Immunotherapy (RIT) Is More Effective Than RIT Alone In Preventing Ragweed-Induced Seasonal Allergic Rhinitis (SAR) Symptoms.
(Abstract #827)
61st Annual Meeting of the American Academy of Allergy, Asthma and Immunology,
San Antonio, TX, March 18-22, 2005.
[Abstract]
