Omalizumab
Omalizumab is a humanized IgG1/κ monoclonal antibody (mAb) that binds to the Fc fragment of IgE122. This mAb inhibits binding of IgE to the high-affinity IgE (FcεRI) receptor on human mast cells and basophils123, 124. Several studies have documented the efficacy of omalizumab in improving allergic asthma and reducing symptoms and exacerbations125-127 also in children and pregnant women128-130. Although omalizumab did not cause FEV1 improvement in RCTs131, 132, there is some evidence that this mAb can improve FEV1 in real-life settings133, 134 and can reduce the thickness of the basement membrane 135, 136 and fibronectin deposits in asthmatic airways 137in addition to preventing exacerbation-induced inflammatory alterations in the airways. IgE-containing serum from asthmatic patients stimulatedin vitro mesenchymal cell proliferation and accumulation of collagen and fibronectin. Both proliferation and matrix deposition were prevented by preincubation of the cells with omalizumab109.