Introduction: Pursuant to identification of various phenotypes of asthma, attempts are made aiming at developing an individualized biological therapy. The key role played by immunoglobulin E (IgE) in an allergic reaction has culminated in the development of omalizumab – a monoclonal antibody against the IgE particle. The studies completed to date have demonstrated the clinical effectiveness of omalizumab therapy, yet the effect of such treatment on airway remodeling has not been fully investigated. Objective: The objective of the present study was the assessment of the effect of biological therapy on airway remodeling, as well as evaluation of the effectiveness of omalizumab treatment in patients with severe allergic asthma. Material and methods: The investigation included 31 patients previously qualified to the omalizumab treatment program by the Biological Treatment in Severe Allergic Asthma Coordinating Team appointed by the President of the National Health Fund. The study was prospective and observational in character; no control group was used. Thirteen patients were additionally subjected to bronchofiberoscopy with broncho-alveolar lavage (BAL) and collection of specimens from the bronchial mucosa. Results and conclusions: The present study demonstrated that biological treatment with omalizumab resulted in improving asthma control and quality ; of life, decreasing the frequency of asthma exacerbation episodes and reducing the dose of systemic glucocorticosteroids. In addition, the present authors observed a tendency towards an improvement of the FEV1 value and a decrease in the number of eosinophils in the peripheral blood, while the group of patients subjected to bronchofiberoscopy showed a decreased number of eosinophils in bronchoalveolar lavage fluids and in bronchial mucosa sections, although no statistical significance was noted. Apart from the clinical improvement, the authors also observed a positive effect of omalizumab treatment on airway remodeling in patients with severe allergic asthma resulting in decreased fibronectin accumulation and a decrease in RBM thickness. The decrease in fibronectin deposits was associated with an improvement in asthma control and improved quality of life, as well as a decreased dose of oral glucocorticosteroids. The omalizumab therapy additionally resulted in a decrease in matrix metalloproteinases (MMP) concentration values in broncho-alveolar lavage (BAL) samples. A decrease in the MMP concentration values was associated with a decrease in the frequency of disease exacerbation episodes and an improvement in symptoms control. The clinical importance and the effect of decreased MPP concentration levels on asthma severity and airway remodeling requir ; e further investigation.
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http://dl.cm-uj.krakow.pl:8080/publication/5128
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ZB-140219 | 2 sie 2024 |
Zastrzeżyńska, Weronika
Potaczek, Daniel Piotr
Marciniak-Sroka, Joanna
Obtułowicz, Aleksander
Kuczia, Paweł
Zajdel, Wojciech J.
Górka, Karolina