{"title":"IgE免疫吸附：技术背景、功能和首次临床经验","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":"{\"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. 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引用次数: 0
摘要
背景：过敏性疾病的患病率在21世纪上升，引起人们对特定治疗和预防策略的关注。由于免疫球蛋白E （IgE）在过敏反应发展中的关键作用，IgE代表了一个关键的靶点治疗。在这种情况下，IgE免疫吸附（IgE- ia）作为一种选择性地从特应性患者血液中去除循环IgE抗体的方法进行了研究。方法：这篇叙述性综述旨在批判性地总结当前关于IgE-IA在过敏性疾病管理方面的见解，从基本原理到技术方面，以及益处和未满足的需求。结果：IgE-IA可作为一种治疗策略，适用于经筛选的变应性疾病患者。通过IgE- ia治疗的IgE消耗可立即改善临床，在需要快速临床反应或经典方法禁忌或无效的急性情况下可能有用。由于随着时间的推移有效性降低，IgE- ia可能是在开始另一种IgE消耗治疗（如omalizumab）之前有效的第一种方法，否则它的开始将因血清IgE水平过高而禁忌。结论：总体而言，IgE-IA是安全且耐受性良好的；然而，由于成本、时间要求、住院治疗需要和手术的侵入性，以及需要静脉置管的相关风险，该手术目前难以在常规临床实践中实施。引自Lo Scalzo L， Sciannamea M, Cafarotti A, Dahdah L, Klimek L, Arasi S. IgE免疫吸附：技术背景，功能和首次临床经验。过敏症[J]；34:139-47https: / / doi.org/10.1007/s40629 - 024 - 00311 - x
IgE immunoadsorption: technical background, functionality, and first clinical experience
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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