May 2001 • Volume 7 • Number 5
New research in immunotherapy for asthma and allergy may bear clinical fruit
BY DENNIS CONNAUGHTON
The discovery of new drugs is like planting an orchard. It takes a long time to bear fruit.
So said the opening speaker at the session "New Developments in Pharmacotherapeutics" during the annual meeting of the American Academy of Allergy, Asthma and Immunology in March.
Among the immunologic discoveries related to asthma and allergy now beginning to bear fruit in the research orchard are new asthma mediators, cytokines that help regulate immunoglobulin E (IgE), the pleiotropic actions of interleukin-4 and interleukin-13, and the critical effect of interleukin-5 on eosinophils, said Anthony Frew, M.D. He heads the department of medical specialties at the University of Southampton in England.
Frew introduced five researchers who presented findings from their recent studies of the latest immunotherapies for asthma and allergies. In time, if the work is confirmed in other research, these new and emerging treatments will reach clinical practice.
William Busse, M.D., head of allergy/clinical immunology at the University of Wisconsin Hospitals and Clinics in Madison, studied the effects of omalizumab (Xolair), a recombinant humanized monoclonal anti-IgE antibody, on perennial allergic rhinitis (PAR) in patients who were unresponsive to previous treatment with nasal steroids or immunotherapy.
He and his colleagues around the world found that omalizumab significantly reduced nasal symptoms in PAR patients unresponsive to other therapies. The medication was both effective and well tolerated, Busse said.
Another study of omalizumab was reported by Jonathan Corren, M.D., associate clinical professor of medicine at UCLA and medical director of the Allergy Research Center in Los Angeles. Corren and coworkers looked at omalizumab's effect on serious asthma exacerbations requiring hospitalization in patients with moderate to severe allergic asthma.
They found that treatment with this drug reduces the risk of serious flareups of asthma in both children and adults with allergic asthma. The treated patients had an 83 percent reduction in hospitalizations for asthma exacerbations.
In an initial phase II clinical trial of immunotherapy using specific immunostimulatory sequences of DNA linked to amb a 1 (the immunodominant allergen in ragweed pollen) for patients with ragweed allergies, Joseph Eiden, Jr., M.D., from Dynavax Technologies Corp. in Berkeley, Calif., and colleagues found that this therapy increases the immunoglobulin G response.
"Since allergen-specific increases in IgG are often associated with successful immunotherapy with conventional vaccines," Eiden said, "these study results indicate the potential utility of the amb a 1 allergen-specific immunotherapy for treatment of ragweed rhinitis."
Theresa Michelle, M.D., from Bio-Technology General Corp. in Iselin, N.J., and others studied the use of an antioxidant enzyme, recombinant human copper/zinc superoxide dismutase (rhSOD), to prevent chronic lung disease in infants born prematurely with respiratory distress syndrome.
At one-year follow-up, the researchers found that rhSOD significantly reduced the need for asthma medication among the treated infants. They concluded that this therapy could provide long-term pulmonary benefits by preventing oxidative injury in the lungs of these babies.
In a study of a computer-based mathematical model of chronic asthma known as Entelos Asthma PhysioLab, Cynthia Stokes, Ph.D., from Entelos, Inc., in Menlo Park, Calif., and coworkers looked at it's the model's application to research into the treatment of exercise-induced asthma.
The computer model was able to predict the efficacy of treatments with luekotriene-receptor antagonists or long-acting beta-agonists in protecting against exercised-induced asthma, Stokes reported. The study also demonstrated the model's ability to show the complex biological mechanisms underlying the clinical results.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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