{"title":"IgE immunoadsorption: technical background, functionality, and first clinical experience","authors":"Lucia Lo Scalzo, Maddalena Sciannamea, Arianna Cafarotti, Lamia Dahdah, Ludger Klimek, Stefania Arasi MD PhD MSc","doi":"10.1007/s15007-025-6520-5","DOIUrl":null,"url":null,"abstract":"<p><b>Background:</b> The prevalence of allergic diseases has risen in the 21st century, drawing attention to specific therapeutic and preventive strategies. Due to the key role of immunoglobulin E (IgE) in the development of allergic reactions, IgE represents a key target treatment. In this scenario, IgE immunoadsorption (IgE-IA) has been investigated as a procedure that selectively removes circulating IgE antibodies from the bloodstream of patients with atopy.</p><p><b>Methods:</b> This narrative review aims to critically summarize the current insights regarding IgE-IA in the context of the management of allergic diseases, ranging from the rationale to the technical aspects, as well as the benefits and unmet needs.</p><p><b>Results:</b> IgE-IA might be a treatment strategy in wellselected patients with allergic diseases. IgE depletion through sessions of IgE-IA results in immediate clinical improvement and might be useful in acute situations when a rapid clinical response is required or when classic approaches are contraindicated or ineffective. Due to the reduced effectiveness over time, IgE-IA could be a valid first approach before starting another IgE depletion therapy, such as omalizumab, when its commencement would otherwise be contraindicated by too-high serum IgE levels.</p><p><b>Conclusion:</b> Overall, IgE-IA is safe and well tolerated; however, this procedure is currently difficult to implement in routine clinical practice because of costs, time demands, need for hospitalization, and the invasiveness of the procedure, with the associated risks related to the necessity of venous catheterization.</p><p><b>Cite this as</b> Lo Scalzo L, Sciannamea M, Cafarotti A, Dahdah L, Klimek L, Arasi S. IgE immunoadsorption: technical background, functionality, and first clinical experience. Allergo J Int 2025; 34:139-47</p><p><b>https://doi.org/10.1007/s40629-024-00311-x</b></p>","PeriodicalId":7418,"journal":{"name":"Allergo Journal","volume":"34 5","pages":"45 - 53"},"PeriodicalIF":1.0000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergo Journal","FirstCategoryId":"1085","ListUrlMain":"https://link.springer.com/article/10.1007/s15007-025-6520-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ALLERGY","Score":null,"Total":0}
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Abstract
Background: The prevalence of allergic diseases has risen in the 21st century, drawing attention to specific therapeutic and preventive strategies. Due to the key role of immunoglobulin E (IgE) in the development of allergic reactions, IgE represents a key target treatment. In this scenario, IgE immunoadsorption (IgE-IA) has been investigated as a procedure that selectively removes circulating IgE antibodies from the bloodstream of patients with atopy.
Methods: This narrative review aims to critically summarize the current insights regarding IgE-IA in the context of the management of allergic diseases, ranging from the rationale to the technical aspects, as well as the benefits and unmet needs.
Results: IgE-IA might be a treatment strategy in wellselected patients with allergic diseases. IgE depletion through sessions of IgE-IA results in immediate clinical improvement and might be useful in acute situations when a rapid clinical response is required or when classic approaches are contraindicated or ineffective. Due to the reduced effectiveness over time, IgE-IA could be a valid first approach before starting another IgE depletion therapy, such as omalizumab, when its commencement would otherwise be contraindicated by too-high serum IgE levels.
Conclusion: Overall, IgE-IA is safe and well tolerated; however, this procedure is currently difficult to implement in routine clinical practice because of costs, time demands, need for hospitalization, and the invasiveness of the procedure, with the associated risks related to the necessity of venous catheterization.
Cite this as Lo Scalzo L, Sciannamea M, Cafarotti A, Dahdah L, Klimek L, Arasi S. IgE immunoadsorption: technical background, functionality, and first clinical experience. Allergo J Int 2025; 34:139-47
期刊介绍：
The Allergo Journal publishes original articles, reviews and case reports, guidelines and position papers in German and English. The topics concern allergological and immunological clinical pictures, current developments in diagnosis and therapy, research work concerning antigens and allergens and aspects related to occupational and environmental medicine. The quality of the contributions is guaranteed by an international board of editors; all contributions will be reviewed by at least two independent peers.
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