Journal article
IgE blockade in autoimmunity: Omalizumab induced remission of bullous pemphigoid
Clinical Immunology, Vol.198, pp.54-56
2019
Abstract
Bullous pemphigoid (BP) is a blistering dermopathy and a prototypic antibody-mediated autoimmune disease. Detection of IgG autoantibodies against hemidesmosomal proteins BP180 and/or BP230 are diagnostic and levels can correlate with disease activity. Therapies include corticosteroids and oral immunosuppressants, while intravenous immunoglobulin and rituximab are reserved for treatment resistant cases. Here we describe a patient with severe BP which was refractory to standard first line therapy, intravenous immunoglobulin and rituximab induced depletion of peripheral B cells. Use of the monoclonal anti-IgE antibody omalizumab resulted in rapid resolution of blistering despite ongoing high levels of anti-skin IgG antibodies. To our knowledge this is the first case of BP responsive to omalizumab after failure of rituximab to be reported. This case adds to emerging data on omalizumab as a novel BP treatment as well as providing new evidence of an independent role for autoreactive IgE-mediated inflammation in the formation of BP skin lesions.
Details
- Title
- IgE blockade in autoimmunity: Omalizumab induced remission of bullous pemphigoid
- Authors/Creators
- T. James (Author/Creator) - Royal Perth HospitalS. Salman (Author/Creator) - The University of Western AustraliaB. Stevenson (Author/Creator) - Queen Elizabeth II Medical CentreC. Bundell (Author/Creator) - Pathwest Laboratory MedicineG. Kelly (Author/Creator) - Royal Perth HospitalD. Nolan (Author/Creator) - Royal Perth HospitalM. John (Author/Creator) - Royal Perth Hospital
- Publication Details
- Clinical Immunology, Vol.198, pp.54-56
- Publisher
- Academic Press Inc.
- Identifiers
- 991005542885207891
- Copyright
- © 2018 Published by Elsevier Inc
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.239 Tissue Barriers
- 1.239.1135 Autoimmune Blistering Diseases
- Web Of Science research areas
- Immunology
- ESI research areas
- Immunology