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Omalizumab Therapy Reduces Fibrocyte Activation in Patients with Severe Allergic Asthma

A study has revealed that the anti-immunoglobulin (Ig) E therapy omalizumab reduces the number of circulating fibrocytes, cell and number of fibrocytes, and α-smooth muscle actin (α-SMA)+ fibrocytes after 3–7 days of culture in patients with severe allergic asthma (SAA).

Omalizumab Therapy Reduces Fibrocyte Activation in Patients with Severe Allergic Asthma
Photo: Human Lungs - Severe Allergic Asthma | InStyleHealth

What Is Severe Allergic Asthma?

Severe Allergic Asthma (SAA) is a breathing condition caused by an allergic reaction, where the airways a person breathes through tighten when an allergen is inhaled. Common allergens include pollen, dander, and mold spores.

This type of asthma is prevalent in both children and adults. People with severe allergic asthma usually feels the allergic reaction following allergen like pollens or dander are inhaled. Symptoms of severe allergic asthma include shortness of breath, coughing, wheezing, stuffy nose, itchy or watery eyes, and rash or hives.

What Causes Severe Allergic Asthma?

For Severe Allergic Asthma are caused by allergens. These allergens are inhaled and trigger asthma symptoms. When a person experiences severe asthma symptoms, it is known as asthma attack.

What Are Common Allergens That Can Trigger Severe Allergic Asthma?

Allergens can be found anywhere in a person’s environment. When an individual has an allergic asthma, inhaling these allergens can trigger severe allergic asthma symptoms. It is significant to be aware what can trigger an asthma so the conditions can be controlled.

There are possible allergens that will surely trigger a severe allergic asthma, and these are the following:

  • Cockroaches: An asthma can be triggered by cockroach’s feces, saliva, and its body parts.
  • Dander: It is the skin flakes or hair usually from household pets like dogs or cats. Hair is often classified with dander as common allergen.
  • Dust mites: These are very small almost microscopic like spiders that live in the soft surfaces of home like carpets, soft furniture coverings, and even clothes. These dust mites will eat skin flakes that a person naturally sheds all the time. The feces and the dust mite itself are considered allergens.
  • Molds: These are typically found in places that hold moisture like basements, molds produce spores that get into the air and when inhaled, it can trigger severe allergic asthma symptoms.
  • Pollens: These are powdery substances which come from plants. The most common types of pollen that trigger allergic asthma are grasses, weeds, and from flowers.

There are some people who suffer from seasonal allergies. This is often connected to spring season because of the blooming of many plants and flowers.

What Are The Symptoms of Severe Allergic Asthma?

The following are the symptoms of Severe Allergic Asthma:

  • Coughing frequently, especially during the evening.
  • Experiencing chest tightness
  • Shortness of breath
  • Wheezing (a whistling noise during breathing).

These symptoms can get very serious during an asthma attack. One has to make sure that a treatment plan is available whenever a severe allergic asthma strikes. Treatment plan includes inhaler or rescue inhaler must be made available as part of the plan.

The Interleukin (IL)-33 and IL-13 are correlated with the effectiveness of omalizumab in inhibiting fibrocyte activation partly contributing to the clinical benefits in lessening lamina propria and thickening of basement membrane.

Researchers, in this study, evaluated the effects of anti-IgE therapy on fibrocyte activities. Experts have measured the expression of CCR7, CXCR4, ST2, and α-SMA in both circulating and cultured fibrocytes from all patients with asthma and repeated this following omalizumab treatment in SAA. Responding to anti-IgE therapy, fibrocytes recruitment, proliferation, and transformation were also evaluated.

Omalizumab treatment greatly improved asthma control and pulmonary function in T2-high SAA, as shown by a decreasing serum levels of IL-33 and IL-13. This also downregulated CXCR4 and CCR7 expressions of fibrocytes, potentially curbing fibrocyte recruitment into the lungs. Moreover, omalizumab suppressed the increased number of fibrocytes and α-SMA+ fibrocytes within the cultured non-adherent non-T (NANT) cells after 3-7 days of culture.

Efficacy of omalizumab in stopping fibrocyte recruitment, proliferation, and myofibroblast transformation through IL-33/ST2 axis was driven by the reduction in serum IL-33 levels. Furthermore, the elevated IL-13 expression in SAA patients boosted the effects of IL-33 by enhancing ST2 expression.

According to researchers that, “Circulating fibrocytes act as precursors of myofibroblasts, contribute to airway remodeling in chronic asthma, and migrate to injured tissues by expressing CXCR4 and CCR7. Anti-IgE therapy improves SAA control and airway remodeling in T2-high SAA.”


Source: Respirology 2021;26:842-850

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