Breathing More Easily

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Science  14 Jan 2000:
Vol. 287, Issue 5451, pp. 193
DOI: 10.1126/science.287.5451.193e

It has been estimated that worldwide 150 million people suffer from asthma, and the prevalence is increasing in most countries. Although the condition can be controlled in most cases by treatment with corticosteroids, the side effects of long-term administration have created the impetus for finding new therapies. As the allergic reaction that leads to asthma is mediated by immunoglobulin E (IgE), one approach has been the blockade of IgE and subsequent release of histamine.

Milgrom et al. conducted a clinical trial of a mouse-derived monoclonal antibody (rhuMAb-E25), which recognizes IgE; to minimize adverse reactions, critical amino acids in the variable region of the mouse immunoglobulin were placed within the background of human immunoglobulin G. In a group of 317 patients with moderate to severe asthma, high or low doses of the antibody (or doses of a placebo) were administered by injection. Relative to the placebo controls, who also were closely monitored and received counseling about treatment adherence, individuals treated with rhuMAb-E25 exhibited dramatic decreases in plasma IgE levels and fewer symptoms, and they reported a higher quality of life. There was a small increase in lung function, as measured by expiratory flow rate, and patients had fewer severe episodes that required the use of bronchodilators.—BJ

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