| ObjectiveBronchial asthma is a heterogeneous disease and has different clinical phenotypes,of which allergic asthma represents the most widespread and easily recognized phenotype of asthma.The treatment of asthma phenotype and its pathogenesis,namely the biological targeted therapy of asthma.The production of immunoglobulin E is an important factor leading to the persistence and aggravation of allergic asthma symptoms.How to block the role of IgE in the immune response opens up a new way for the treatment of allergic asthma.By targeting IgE binding,omalizumab effectively inhibits mast cell and basophil activation and degranulation,blocking the root of the inflammatory cascade mediated by omalizumab in allergic asthma attacks and reducing asthma onset.Although the ICS and LABA combination,show good clinical curative effect,has now become the drug of choice for asthma control,but there are still some patients exist such problems as poor control,decreased sensitivity.As an adjunct,omalizumab has demonstrated the advantage of targeted IgE therapy in the treatment of allergic asthma and other allergic diseases.This study will investigate the effects of omalizumab on the percentage of eosinophils in blood,serum total IgE level,pulmonary function and improvement of clinical symptoms,and ACT score in patients with asthma in addition to conventional ICS+LABA treatment.Materials and MethodsA total of 32 patients with moderate to severe allergic asthma who received omalizumab in the respiratory department of Shandong Qianfoshan Hospital,Shandong University from April 2020 to December 2020 were collected.Pre-treatment omalizumab group:17 males and 15 females,aged 19-64 years;Omalizumab post-treatment group:All patients were in the pre-treatment group who received regular subcutaneous injection of omalizumab.There was no significant difference in gender and age composition between the two groups(P≥0.05).The changes of serum eosinophil percentage,serum total IgE level,FEV1,FEV1%pred,ACT score and FeNO measurement before and after 16 weeks of omalizumab treatment were monitored and compared..ResultsAfter 16 consecutive weeks of omalizumab subcutaneous injection,the serum total IgE level of asthma patients(340.44±157.96)IU/ml was significantly higher than that before treatment(296.72±157.38)IU/ml,the difference was statistically significant(t=11.509,P<0.01).The percentage of eosinophils in blood decreased from(0.23±0.09)%before treatment to(0.17±0.07)%,and the difference before and after treatment was statistically significant(t=8.925,P<0.01).FEV1 increased from(2.53±0.25)L before treatment to(2.65±0.25)L,the difference was statistically significant(t=9.251,P<0.01).FEV1%pred increased from(83.02±8.65)%before treatment to(86.33±7.58)%,and the difference before and after treatment was statistically significant(t=9.251,P<0.01).FeNO decreased from(137.00±63.71)PPB to(69.16±36.09)PPB,and the difference was statistically significant(t=9.994,P<0.01).ACT score increased from(19.63±1.96)before treatment to(23.56±1.05)before and after treatment(t=13.876,P<0.01).ConclusionBudesonide/Formoterol powder inhalation is the cornerstone of long-term treatment for patients with asthma.Based on this,the assessment of allergic status in body and the addition of omalizumab can effectively inhibit airway inflammation.It is better than budesonide/formoterol alone in improving lung function,reducing acute attacks and improving quality of life,and omalizumab has shown good safety and tolerability,opening up a new way of biological targeted therapy for asthma.However,these results need to be further validated in larger,prospective studies. |
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