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Intranasal administration of allergen increases specific IgE whereas intranasal omalizumab does not increase serum IgE levels : a pilot study

(2018) ALLERGY. 73(5). p.1003-1012
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Abstract
Background: Administration of the therapeutic anti-IgE antibody omalizumab to patients induces strong increases in IgE antibody levels. Objective: To investigate the effect of intranasal administration of major birch pollen allergen Bet v 1, omalizumab or placebo on the levels of total and allergen-specific IgE in patients with birch pollen allergy. Methods: Based on the fact that intranasal allergen application induces rises of systemic allergen-specific IgE, we performed a double-blind placebo-controlled pilot trial in which birch pollen allergic subjects were challenged intranasally with omalizumab, placebo or birch pollen allergen Bet v 1. Total and allergen-specific IgE, IgG and basophil sensitivity were measured before and 8weeks after challenge. For control purposes, total, allergen-specific IgE levels and omalizumab-IgE complexes as well as specific IgG levels were studied in subjects treated subcutaneously with either omalizumab or placebo. Effects of omalizumab on IgE production by IL-4/anti-CD40-treated PBMCs from allergic patients were studied invitro. Results: Intranasal challenge with Bet v 1 induced increases in Bet v 1-specific IgE levels by a median of 59.2%, and this change differed significantly from the other treatment groups (P=.016). No relevant change in allergen-specific and total IgE levels was observed in subjects challenged with omalizumab. Addition of omalizumab did not enhance IL-4/anti-CD40-induced IgE production invitro. Significant rises in total IgE (mean IgE before: 131.83 kU/L to mean IgE after: 505.23 kU/L) and the presence of IgE-omalizumab complexes were observed after subcutaneous administration of omalizumab. Conclusion: Intranasal administration of allergen induced rises of allergen-specific IgE levels, whereas intranasal administration of omalizumab did not enhance systemic total or allergen-specific IgE levels.
Keywords
allergen, half-life, IgE, intranasal challenge, omalizumab, FC-EPSILON-RI, ANTI-IGE, B-CELLS, MONOCLONAL-ANTIBODY, POLLEN ALLERGEN, NASAL-MUCOSA, MAST-CELLS, RESPONSES, THERAPY, EXPRESSION

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Citation

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Chicago
Eckl-Dorna, J, R Fröschl, C Lupinek, R Kiss, P Gattinger, K Marth, R Campana, et al. 2018. “Intranasal Administration of Allergen Increases Specific IgE Whereas Intranasal Omalizumab Does Not Increase Serum IgE Levels : a Pilot Study.” Allergy 73 (5): 1003–1012.
APA
Eckl-Dorna, J., Fröschl, R., Lupinek, C., Kiss, R., Gattinger, P., Marth, K., Campana, R., et al. (2018). Intranasal administration of allergen increases specific IgE whereas intranasal omalizumab does not increase serum IgE levels : a pilot study. ALLERGY, 73(5), 1003–1012.
Vancouver
1.
Eckl-Dorna J, Fröschl R, Lupinek C, Kiss R, Gattinger P, Marth K, et al. Intranasal administration of allergen increases specific IgE whereas intranasal omalizumab does not increase serum IgE levels : a pilot study. ALLERGY. 2018;73(5):1003–12.
MLA
Eckl-Dorna, J et al. “Intranasal Administration of Allergen Increases Specific IgE Whereas Intranasal Omalizumab Does Not Increase Serum IgE Levels : a Pilot Study.” ALLERGY 73.5 (2018): 1003–1012. Print.
@article{8609403,
  abstract     = {Background: Administration of the therapeutic anti-IgE antibody omalizumab to patients induces strong increases in IgE antibody levels. 
Objective: To investigate the effect of intranasal administration of major birch pollen allergen Bet v 1, omalizumab or placebo on the levels of total and allergen-specific IgE in patients with birch pollen allergy. 
Methods: Based on the fact that intranasal allergen application induces rises of systemic allergen-specific IgE, we performed a double-blind placebo-controlled pilot trial in which birch pollen allergic subjects were challenged intranasally with omalizumab, placebo or birch pollen allergen Bet v 1. Total and allergen-specific IgE, IgG and basophil sensitivity were measured before and 8weeks after challenge. For control purposes, total, allergen-specific IgE levels and omalizumab-IgE complexes as well as specific IgG levels were studied in subjects treated subcutaneously with either omalizumab or placebo. Effects of omalizumab on IgE production by IL-4/anti-CD40-treated PBMCs from allergic patients were studied invitro. 
Results: Intranasal challenge with Bet v 1 induced increases in Bet v 1-specific IgE levels by a median of 59.2%, and this change differed significantly from the other treatment groups (P=.016). No relevant change in allergen-specific and total IgE levels was observed in subjects challenged with omalizumab. Addition of omalizumab did not enhance IL-4/anti-CD40-induced IgE production invitro. Significant rises in total IgE (mean IgE before: 131.83 kU/L to mean IgE after: 505.23 kU/L) and the presence of IgE-omalizumab complexes were observed after subcutaneous administration of omalizumab. 
Conclusion: Intranasal administration of allergen induced rises of allergen-specific IgE levels, whereas intranasal administration of omalizumab did not enhance systemic total or allergen-specific IgE levels.},
  author       = {Eckl-Dorna, J and Fröschl, R and Lupinek, C and Kiss, R and Gattinger, P and Marth, K and Campana, R and Mittermann, I and Blatt, K and Valent, P and Selb, R and Mayer, A and Gangl, K and Steiner, I and Gamper, J and Perkmann, T and Zieglmayer, P and Gevaert, Philippe and Valenta, R and Niederberger, V},
  issn         = {0105-4538},
  journal      = {ALLERGY},
  keywords     = {allergen,half-life,IgE,intranasal challenge,omalizumab,FC-EPSILON-RI,ANTI-IGE,B-CELLS,MONOCLONAL-ANTIBODY,POLLEN ALLERGEN,NASAL-MUCOSA,MAST-CELLS,RESPONSES,THERAPY,EXPRESSION},
  language     = {eng},
  number       = {5},
  pages        = {1003--1012},
  title        = {Intranasal administration of allergen increases specific IgE whereas intranasal omalizumab does not increase serum IgE levels : a pilot study},
  url          = {http://dx.doi.org/10.1111/all.13343},
  volume       = {73},
  year         = {2018},
}

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