奥马珠单抗治疗慢性自发性荨麻疹的进展

doi:10.3760/cma.j.issn.0412-4030.2019.01.020

中华皮肤科杂志 ›› 2019, Vol. 52 ›› Issue (1): 60-63.doi: 10.3760/cma.j.issn.0412-4030.2019.01.020

奥马珠单抗治疗慢性自发性荨麻疹的进展

郑林石臻睿何敏彤谭国珍

中山大学孙逸仙纪念医院皮肤科，广州 510120

收稿日期:2018-02-05 修回日期:2018-03-24 发布日期:2019-01-02
通讯作者: 谭国珍 E-mail:13678906833@163.com

Omalizumab for the treatment of chronic spontaneous urticaria

Zheng Lin, Shi Zhenrui, He Mintong, Tan Guozhen

Department of Dermatology, Sun Yat⁃sen Memorial Hospital, Sun Yat⁃sen University, Guangzhou 510120, China

Received:2018-02-05 Revised:2018-03-24 Published:2019-01-02
Contact: Tan Guozhen E-mail:13678906833@163.com

摘要/Abstract

摘要： 【摘要】慢性自发性荨麻疹指不明原因反复发作风团超过6周，伴或不伴血管神经性水肿。其发病的中心环节是肥大细胞和嗜碱性粒细胞激活、脱颗粒。奥马珠单抗是一种人源化、重组单克隆IgG抗体，能选择性结合游离IgE抗体Fc段，阻断IgE?FCεRⅠ轴所引起的肥大细胞、嗜碱性粒细胞激活。已发布评价奥马珠单抗治疗慢性自发性荨麻疹的Ⅲ期临床试验有3项，证实了奥马珠单抗在治疗难治型慢性自发性荨麻疹的有效性和安全性。

关键词: 荨麻疹；免疫球蛋白ε链；奥马珠单抗；慢性自发性荨麻疹 ,

Abstract: 【Abstract】 Chronic spontaneous urticaria is defined as recurrent wheals of unknown etiology for more than 6 weeks, with or without angioneurotic edema. The key step in the pathogenesis of chronic spontaneous urticaria is activation and degranulation of mast cells and basophils. Omalizumab, a recombinant humanized IgG monoclonal antibody, can selectively bond the Fc region of free IgE antibodies, and then block IgE-FCeRⅠ-mediated activation of mast cells and basophils. Three phase Ⅲ clinical trials have been reported on the efficacy of omalizumab in the treatment of chronic spontaneous urticaria, which confirm the efficacy and safety of omalizumab in the treatment of refractory chronic spontaneous urticaria.

Key words: Urticaria, Immunoglobulin epsilon?chains, Omalizumab, Chronic spontaneous urticaria

中图分类号:

郑林石臻睿何敏彤谭国珍. 奥马珠单抗治疗慢性自发性荨麻疹的进展[J]. 中华皮肤科杂志, 2019,52(1):60-63. doi:10.3760/cma.j.issn.0412-4030.2019.01.020

Zheng Lin, Shi Zhenrui, He Mintong, Tan Guozhen. Omalizumab for the treatment of chronic spontaneous urticaria[J]. Chinese Journal of Dermatology, 2019, 52(1): 60-63.doi:10.3760/cma.j.issn.0412-4030.2019.01.020

参考文献 25

［1］	Maurer M, Church MK, Gonçalo M, et al. Management and treatment of chronic urticaria （CU）［J］. J Eur Acad Dermatol Venereol, 2015,29 Suppl 3:16⁃32. doi: 10.1111/jdv.13198.
［2］	D′Amato G, Stanziola A, Sanduzzi A, et al. Treating severe allergic asthma with anti⁃IgE monoclonal antibody （omalizumab）: a review［J］. Multidiscip Respir Med, 2014,9（1）:23. doi: 10.1186/2049⁃6958⁃9⁃23.
［3］	Spector SL, Tan RA. Effect of omalizumab on patients with chronic urticaria［J］. Ann Allergy Asthma Immunol, 2007,99（2）:190⁃193. doi: 10.1016/S1081⁃1206（10）60644⁃8.
［4］	Godse KV. Omalizumab in severe chronic urticaria［J］. Indian J Dermatol Venereol Leprol, 2008,74（2）:157⁃158.
［5］	Kolkhir P, Church MK, Weller K, et al. Autoimmune chronic spontaneous urticaria: what we know and what we do not know［J］. J Allergy Clin Immunol, 2017,139（6）:1772⁃1781.e1. doi: 10.1016/j.jaci.2016.08.050.
［6］	Beck LA, Marcotte GV, MacGlashan D, et al. Omalizumab⁃induced reductions in mast cell FcεRI and function［J］. J Allergy Clin Immunol, 2004,114（3）:527⁃530. doi: 10.1016/j.jaci. 2004.06.032.
［7］	Hsu CL, Shiung YY, Lin BL, et al. Accumulated immune complexes of IgE and omalizumab trap allergens in an in vitro model［J］. Int Immunopharmacol, 2010,10（4）:533⁃539. doi: 10. 1016/j.intimp.2010.02.001.
［8］	Kalesnikoff J, Huber M, Lam V, et al. Monomeric IgE stimulates signaling pathways in mast cells that lead to cytokine production and cell survival［J］. Immunity, 2001,14（6）:801⁃811.
［9］	Chang TW, Chen C, Lin CJ, et al. The potential pharmacologic mechanisms of omalizumab in patients with chronic spontaneous urticaria［J］. J Allergy Clin Immunol, 2015,135（2）:337⁃342. doi: 10.1016/j.jaci.2014.04.036.
［10］	Chan MA, Gigliotti NM, Dotson AL, et al. Omalizumab may decrease IgE synthesis by targeting membrane IgE+ human B cells［J］. Clin Transl Allergy, 2013,3（1）:29. doi: 10.1186/2045⁃7022⁃3⁃29.
［11］	Saini S, Rosen KE, Hsieh HJ, et al. A randomized, placebo⁃controlled, dose⁃ranging study of single⁃dose omalizumab in patients with H1⁃antihistamine⁃refractory chronic idiopathic urticaria［J］. J Allergy Clin Immunol, 2011,128（3）:567⁃573.e1. doi: 10.1016/j.jaci.2011.06.010.
［12］	Gericke J, Metz M, Ohanyan T, et al. Serum autoreactivity predicts time to response to omalizumab therapy in chronic spontaneous urticaria［J］. J Allergy Clin Immunol, 2017,139（3）:1059⁃1061.e1. doi: 10.1016/j.jaci.2016.07.047.
［13］	Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. The 2017 revision and Update［J］. Allergy, 2018. doi: 10.1111/all.13397.
［14］	Ertas R, Ozyurt K, Ozlu E, et al. Increased IgE levels are linked to faster relapse in patients with omalizumab⁃discontinued chronic spontaneous urticaria［J］. J Allergy Clin Immunol, 2017,140（6）:1749⁃1751. doi: 10.1016/j.jaci.2017.08.007.
［15］	Fine LM, Bernstein JA. Urticaria guidelines: consensus and controversies in the European and American guidelines［J］. Curr Allergy Asthma Rep, 2015,15（6）:30. doi: 10.1007/s11882⁃015⁃0535⁃z.
［16］	McCormack PL. Omalizumab: a review of its use in patients with chronic spontaneous urticaria［J］. Drugs, 2014,74（14）:1693⁃1699. doi: 10.1007/s40265⁃014⁃0290⁃9.
［17］	Labrador⁃Horrillo M, Ferrer M. Profile of omalizumab in the treatment of chronic spontaneous urticaria［J］. Drug Des Devel Ther, 2015,9:4909⁃4915. doi: 10.2147/DDDT.S56004.
［18］	Saini SS, Bindslev⁃Jensen C, Maurer M, et al. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized, placebo⁃controlled study［J］. J Invest Dermatol, 2015,135（1）:67⁃75. doi: 10.1038/jid.2014.306.
［19］	Maurer M, Rosén K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria［J］. N Engl J Med, 2013,368（10）:924⁃935. doi: 10.1056/NEJMoa1215372.
［20］	Kaplan A, Ledford D, Ashby M, et al. Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy［J］. J Allergy Clin Immunol, 2013,132（1）:101⁃109. doi: 10.1016/j.jaci.2013.05.013.
［21］	Casale TB, Bernstein JA, Maurer M, et al. Similar efficacy with omalizumab in chronic idiopathic/spontaneous urticaria despite different background therapy［J］. J Allergy Clin Immunol Pract, 2015,3（5）:743⁃750.e1. doi: 10.1016/j.jaip.2015.04.015.
［22］	Giménez⁃Arnau AM. Omalizumab for treating chronic spontaneous urticaria: an expert review on efficacy and safety［J］. Expert Opin Biol Ther, 2017,17（3）:375⁃385. doi: 10.1080/14712598.2017. 1285 903.
［23］	Busse W, Corren J, Lanier BQ, et al. Omalizumab, anti⁃IgE recombinant humanized monoclonal antibody, for the treatment of severe allergic asthma［J］. J Allergy Clin Immunol, 2001,108（2）:184⁃190. doi: 10.1067/mai.2001.117880.
［24］	Zhao ZT, Ji CM, Yu WJ, et al. Omalizumab for the treatment of chronic spontaneous urticaria: a meta⁃analysis of randomized clinical trials［J］. J Allergy Clin Immunol, 2016,137（6）:1742⁃1750.e4. doi: 10.1016/j.jaci.2015.12.1342.
［25］	Maurer M, Metz M, Brehler R, et al. Omalizumab treatment in patients with chronic inducible urticaria: a systematic review of published evidence［J］. J Allergy Clin Immunol, 2018,141（2）:638⁃649. doi: 10.1016/j.jaci.2017.06.032.

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奥马珠单抗治疗慢性自发性荨麻疹的进展

Omalizumab for the treatment of chronic spontaneous urticaria

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