4.5 Article

The Role of IgE in Upper and Lower Airway Disease: More Than Just Allergy!

Journal

CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY
Volume 62, Issue 1, Pages 200-215

Publisher

HUMANA PRESS INC
DOI: 10.1007/s12016-021-08901-1

Keywords

Asthma; Immunoglobulin E; Lower airway disease; Nasal polyps; Rhinitis; Upper airway disease

Funding

  1. Genentech, Inc., a member of the Roche Group
  2. Novartis Pharma AG
  3. Novartis Pharmaceuticals Corporation

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Immunoglobulin E (IgE) plays a key role in both allergic and non-allergic airway diseases. Understanding its role as a unifying component of upper and lower airway diseases is important for diagnosis and treatment.
Immunoglobulin E (IgE) is a well-known key factor in allergic airway disease; however, its central role in non-allergic airway inflammation is often underestimated. In some airway diseases, IgE is produced as a result of allergic sensitization. However, in others, IgE production occurs despite the lack of a specific allergen. Although multiple pathways contribute to the production of IgE in airway disease, it is its activity in mediating the inflammatory response that is associated with disease. Therefore, an understanding of IgE as the unifying component of upper and lower airway diseases has important implications for both diagnosis and treatment. Understanding the role of IgE in each upper and lower airway disease highlights its potential utility as a diagnostic marker and therapeutic target. Further classification of these diseases by whether they are IgE mediated or non-IgE mediated, rather than by the existence of an underlying allergic component, accounts for both systemic and localized IgE activity. Improvements in diagnostic methodologies and standardization of clinical practices with this classification in mind can help identify patients with IgE-mediated diseases. In doing so, this group of patients can receive optimal care through targeted anti-IgE therapeutics, which have already demonstrated efficacy across numerous IgE-mediated upper and lower airway diseases.

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