Skip to main content

Omalizumab - Anti-IgE Monoclonal Antibodies

It is a new approach to the treatment of asthma. It is a recombinant humanized gamma immunoglobulin (IgG)1 monoclonal antibody that is targeted against the portion of IgE that binds to its receptors (FC -R1 and FC -R2 receptors) on mast cells and other inflammatory cells.


It inhibits the binding of IgE to mast cells but does not activate IgE already bound to these cells and thus does not provoke mast cell degranulation. It may also inhibit IgE synthesis by B lymphocytes.  In addition, omalizumab causes down-regulation of IgE receptors on mast cells and basophils.


Administration of omalizumab to asthmatic individuals for 10 weeks lowers plasma IgE to undetectable levels and significantly reduces the magnitude of both the early and the late bronchospastic responses to antigen challenge. 

Repeated administration lessens asthma severity and reduces the corticosteroid requirement in patients with moderate to severe disease, especially those with a clear environmental antigen precipitating factor, and improves nasal and conjunctival symptoms in patients with perennial or seasonal allergic rhinitis. Omalizumab's most important effect is reduction of the frequency and severity of asthma exacerbations, even while enabling a reduction in corticosteroid requirements.


Omalizumab treatment reduced exacerbations requiring hospitalization by 88%.


Omalizumab is recommended in the guidelines and in a recent review for asthma patients with allergies whose asthma is not controlled with long-acting beta agonist, high-dose inhaled steroids, and leukotriene modifier therapy or when the use of those medications is associated with intolerable side effects.


The patient's pretreatment serum IgE level (IU/mL) and body weight (kg) are used to determine doses (mg) and dosing frequency. Doses of more than 150 mg are divided among more than 1 injection site so that a single injection site never exceeds 150 mg
.
Labels:

Comments

  1. Muhammad HassanDecember 13, 2017 at 8:32 PM

    Superbly written article, if only all bloggers offered the same content as you, the internet would be a far better place.. ELISA Kits

    ReplyDelete

Post a Comment

Popular posts from this blog

Hypokalemia - Potassium replacement calculation

 DEFINITION  Hypokalemia is defined as a serum potassium level of less than 3.5 mmol/L. Normal level= 3.5-5.5 mmol/L. It is encountered in >20% of patients. Patients are usually asymptomatic but severe arrhythmias and rhabdomyolysis can occur. Non-specific complaints include easy fatiguability and skeletal muscle weakness. The preferred method of replacement is via the oral route but at times this is not possible. The article below will give you an idea about how to calculate the amount of KCl to be given I.V. 1) Potassium deficit in mmol is calculated as given below: K deficit  (mmol) = (K normal lower limit  - K measured ) x kg body weight x 0.4 2) Daily potassium requirement is around 1 mmol/Kg body weight. 3) 13.4 mmol of potassium found in 1 g KCl . ( molecular weight KCl = 39.1 + 35.5 = 74.6) Suppose we get an asymptomatic patient of  70 Kg with a serum potassium level of 3.0 mmol/L and he is on nil by mouth but having...
50 comments
Read more

Endomysium, Perimysium and epimysium - definition, histology

Each muscle fibre is closely surrounded by connective tissue. This acts as a support for the muscle fibres and unites them to each other. 1) Each muscle fibres is surrounded by delicate connective tissue that is called the endomysium . 2) Individual fasciculi are enclosed by a stronger sheath of connective tissue called the perimysium . 3) The entire muscle is surrounded by connective tissue called the epimysium . This is illustrated by the schematic diagram below. 1= perimysium, 2= endomysium, 3= fasciculus. At the junction of a muscle with a tendon, the fibres of the endomysium, the perimysium and the epimysium become continuous with the fibres of the tendon. First published on: 27 December 2016
Post a Comment
Read more

The plantar reflex - Babinski's sign

The plantar response is an important test to identify an upper motor neuron lesion.  PROCEDURE  To elicit it, the muscles of the lower limbs must be relaxed. The outer edge of the sole of the foot is stimulated by firmly scratching a blunt object like a key or a stick along it from the heel towards the little toe. This is what  Joseph Babinski did in the year 1896. He described the 'great toe sign' that year and then in 1903 the 'toe abduction or fan sign'. Nowadays, a final medial movement across the sole of the metatarsus is also done. i.e. we start at the heel to the little toe and finally arcing to the big toe. The final arcing movement is absent in the original Babinski plantar response test. Babinski sign refers to a combination of 'the great toe sign' and the 'fan sign'.  SIGNIFICANCE  The normal response is plantar flexion of the toes (down going) and they are drawn together. More precisely, there is flexion of the big toe and addu...
4 comments
Read more

Differences between hyperemia and congestion

Hyperemia and congestion both indicate a local increased volume of blood in a particular tissue. Hyperemia is an active process that result from augmented blood flow due to arteriolar dilation (e.g. at sites of inflammation or in skeletal muscle during exercise). The affected tissue is redder than normal because of engorgement with oxygenated blood. Congestion, on the other hand, is a passive process resulting from impaired venous return out of a tissue. It may occur due to systemic causes like cardiac failure or a local cause like isolated venous obstruction. The tissue is cyanosed because the worsening congestion leads to accumulation of deoxygenated hemoglobin in the affected tissues. 
2 comments
Read more

Apgar scoring - table, mnemonic

 INTRODUCTION  The  Apgar score  was devised in 1952 by Dr Virginia Apgar (anesthesiologist) as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after birth.  This helps to identify those requiring resuscitation and can also be used to predict survival in the neonatal period.   MNEMONIC  A mnemonic for learning purposes includes: A - Appearance (skin colour) P - Pulse (heart rate) G - Grimace (reflex irritability) A - Activity (muscle tone) R - Respiration  Another mnemonic is also useful:  How -   Heart rate Ready - Respiration Is -        Irritability This -    Tone Child -   Colour Apgar scoring is divided into 1 and 5-min scores.  1-MIN SCORE    Sixty seconds after complete birth, the five parameters specified in the table above must be eval...
1 comment
Read more