The past, present, and future of anti-IgE therapy

Immunoglobulin E is the last of the discovered immunoglobulins and is the main mediator of allergic reactions. Its role in allergy pathogenesis led to development of the first immunobiological drug for treatment of allergic diseases — omalizumab. Omalizumab binds free immunoglobulin E, preventing its binding to high-affinity receptors, thereby blocking the cascade of allergic inflammation. This review discusses the results of the main studies of omalizumab for treatment of severe bronchial asthma, chronic spontaneous urticaria, and other allergic diseases. The drug has been used for more than twenty years, but the research is still ongoing. Thus in 2024, omalizumab was approved for use in prevention of anaphylaxis in patients with food allergies. The drug is being studied in combination with allergen-specific immunotherapy, as well as in patients with allergic bronchopulmonary aspergillosis.