Document Detail


Kinetics of mast cell, basophil, and oral food challenge responses in omalizumab-treated adults with peanut allergy.
MedLine Citation:
PMID:  22800401     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Monoclonal antibodies directed at IgE demonstrate clinical efficacy in subjects with peanut allergy, but previous studies have not addressed the kinetics of the clinical response or the role of mast cells and basophils in the food-induced allergic response.
OBJECTIVE: We sought to determine the kinetics of the clinical response to omalizumab and whether clinical improvement is associated with either mast cell or basophil suppression.
METHODS: Subjects with peanut allergy were treated with omalizumab for 6 months and assessed for clinical and cellular responses. At baseline, subjects had a double-blind, placebo-controlled oral food challenge (OFC), skin prick test titration (SPTT), and basophil histamine release (BHR) to peanut. BHR was repeated at week 2 and then weekly until it decreased to less than 20% of baseline values. The OFCs and SPTTs were repeated after the BHR reduction (or at week 8 if BHR did not decrease) and again at 6 months.
RESULTS: Fourteen subjects enrolled in the study. At the second food challenge, there was a significant increase in the threshold dose of peanut inducing allergic symptoms (80 to 6500 mg, P < .01). Peanut-induced BHR was either completely suppressed (n = 5) or 10-fold more allergen was required to induce maximal BHR (n = 9), and SPTT responses were not significantly changed from baseline. After 6 months of omalizumab, further changes in the OFC threshold dose or BHR were not observed, but a significant suppression in SPTTs was identified.
CONCLUSIONS: The clinical response to omalizumab occurs early in treatment when the basophil, but not the mast cell, is suppressed, supporting a role for the basophil in acute food reactions.
Authors:
Jessica H Savage; Jean-Paul Courneya; Patricia M Sterba; Donald W Macglashan; Sarbjit S Saini; Robert A Wood
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-07-15
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  130     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-01-31     Revised Date:  2014-02-27    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1123-1129.e2     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adolescent
Adult
Anti-Allergic Agents / administration & dosage*,  adverse effects
Antibodies, Anti-Idiotypic / administration & dosage*,  adverse effects
Antibodies, Monoclonal, Humanized / administration & dosage*,  adverse effects
Basophils / drug effects*,  immunology
Histamine / metabolism
Humans
Immunization
Immunosuppression
Mast Cells / drug effects*,  immunology
Middle Aged
Peanut Hypersensitivity / drug therapy*,  immunology
Skin Tests
Young Adult
Grant Support
ID/Acronym/Agency:
AI070345/AI/NIAID NIH HHS; T32AI007056-31/AI/NIAID NIH HHS; U19 AI070345/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Allergic Agents; 0/Antibodies, Anti-Idiotypic; 0/Antibodies, Monoclonal, Humanized; 0/omalizumab; 820484N8I3/Histamine
Comments/Corrections

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