Versiones
- 18-12-2020 (5)
- 16-12-2020 (4)
Palabras clave
Bloqueo de inmunoglobulina E
Interferón
Omalizumab
Resumen
El asma es una enfermedad inflamatoria crónica y heterogénea que afecta las vías respiratorias inferiores tanto de niños como de adultos. Los pacientes en quienes se han abordado factores modificables y continúan con episodios graves de asma aún después de la aplicación de dosis altas de corticosteroides se les diagnostica con asma grave; esta se asocia con mayor mortalidad y hospitalizaciones, así como con menor calidad de vida y mayores costos de atención médica. Se han identificado mecanismos inmunoinflamatorios tipo 2 altos, bajos y mixtos, en los cuales la inmunoglobulina E es un biomarcador prominente para el asma de inicio temprano y el asma de inicio tardío no alérgico. El bloqueo de la inmunoglobulina E disminuye indirectamente la expresión de su receptor de alta afinidad, disminuyendo la producción de citocinas tipo 2 e inhibiendo la inflamación eosinofílica, así como la modulación de la inflamación tipo 2. Por otro lado, la evidencia preclínica y clínica respalda la existencia de una estrecha contrarregulación de las vías del receptor de inmunoglobulina E de alta afinidad y del interferón, y un posible mecanismo de prevención de exacerbaciones inducidas por virus. La siguiente revisión resume la larga experiencia clínica del resultado de bloquear la inmunoglobulina E en el asma grave.Referencias
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