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Omalizumab for treatment of allergic rhinitis

机译：奥马珠单抗治疗过敏性鼻炎

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Introduction: Immunoglobulin E (IgE) is a key pathogenic factor of allergic rhinitis, a prevalent disease adversely affecting quality of life and productivity. Areas covered: Binding of inhaled allergens to IgE on the surface of basophils and mast cells, with subsequent cross-linkage of IgE and aggregation of high-affinity receptors for IgE (FcεRI), triggers the release of inflammatory mediators, followed by the onset of allergic rhinitis symptoms. Current therapeutic strategies include corticosteroids, mast cell stabilizers, leukotriene receptor antagonists, anticholinergics, antihistamines and allergen immunotherapy. Removal of circulating free IgE by the recombinant humanized monoclonal anti-IgE antibody, omalizumab (Xolair), represents a novel therapeutic approach. Omalizumab selectively binds to the Cε3 domain of IgE at the site of FcεR1 binding, thus blocking binding of IgE to effector cells. We review omalizumab's clinical efficacy, administration, use with immunotherapy and safety in allergic rhinitis. Expert opinion: Omalizumab may provide a new treatment strategy for allergic rhinitis. The high cost of omalizumab precludes its chronic use for allergic rhinitis and it is not FDA approved for this indication; however, its periodic use may be justified in treatment resistant patients, especially those with seasonal disease.
机译：简介：免疫球蛋白E（IgE）是过敏性鼻炎的关键致病因素，这是一种对生活质量和生产力产生不利影响的流行疾病。覆盖的区域：吸入的过敏原与嗜碱性粒细胞和肥大细胞表面的IgE结合，随后发生IgE交联和IgE高亲和力受体（FcεRI）聚集，触发炎症介质的释放，随后开始过敏性鼻炎的症状。当前的治疗策略包括皮质类固醇，肥大细胞稳定剂，白三烯受体拮抗剂，抗胆碱能药，抗组胺药和过敏原免疫疗法。重组人源化单克隆抗IgE抗体奥马珠单抗（Xolair）去除循环中游离IgE代表了一种新颖的治疗方法。奥马珠单抗在FcεR1结合位点选择性结合IgE的Cε3结构域，从而阻断IgE与效应细胞的结合。我们回顾了奥马珠单抗在变应性鼻炎中的临床疗效，给药方式，免疫疗法的使用和安全性。专家意见：奥马珠单抗可能为过敏性鼻炎提供新的治疗策略。奥马珠单抗的高成本使其无法长期用于变应性鼻炎，并且未经FDA批准用于该适应症。然而，对于有抗药性的患者，尤其是季节性疾病患者，定期使用它可能是合理的。

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