Affiliation:
1. Department of Child and Adolescent Health, Center of Pediatric Pulmonology and Allergology Aarhus University Hospital Aarhus Denmark
2. Department of Child and Adolescent Health Aarhus University Hospital Aarhus Denmark
3. Department of Clinical Medicine, Department of Clinical Immunology, Aarhus University Hospital Aarhus University Aarhus Denmark
Abstract
AbstractBackgroundImmune‐based therapy targeting immunoglobulin E (IgE), anti‐IgE treatment, has emerged as an adjunct treatment for children with severe allergic asthma. After start of anti‐IgE treatment, an effect of the treatment cannot be monitored by Total‐IgE, because current methods measure both bound and free IgE molecules. Basophil activation test may be very useful for monitoring anti‐IgE treatment efficacy. The objective of this paper is to evaluate if basophil activation test is applicable in regulating the anti‐IgE treatment.MethodsA case series of 20 children with IgE‐mediated severe allergic asthma were treated according to guidelines with anti‐IgE (Omalizumab). Blood samples were drawn for total IgE, specific IgE, number of IgE receptors (FcεRI) and basophil sensitivity were measured at baseline before anti‐IgE treatment and 4 months after initiation of anti‐IgE treatment.ResultsA total of 19 out of 20 children had statistically significant and clinically relevant effects of anti‐IgE treatment on symptom score, lung function and medication. All 20 children had a significant reduction in basophil allergen sensitivity and the number of IgE receptors (FcεRI) on blood basophils. Anti‐IgE treatment was found to be well controlled by measuring basophil allergen sensitivity and FceRI density on blood basophils.ConclusionThis cohort study demonstrates a promising method, measuring basophil allergen sensitivity and in particular blood basophil FceRI density, concerning the monitoring of anti‐IgE treatment in different clinical situations. There are no randomized controlled trials evaluating this method in clinical settings.