El efecto del tratamiento anti-IgE en enfermedades inmunomediadas

Abstract

Chronic urticaria and severe allergic asthma are conditions with high prevalence and immunological complexity. This can represent a challenge in clinical practice to achieve adequate disease control, leading to the incorporation of biological therapies such as omalizumab. Several biomarkers are useful for monitoring, prognosis, and therapeutic response, but questions remain regarding the underlying immunological mechanisms associated with this drug’s mode of action beyond IgE inhibition. The main objective of this study was to analyze the effect of anti-IgE therapy on the adaptive immune response, with special attention to T lymphocyte subpopulations. The aim was to assess their potential as peripheral blood biomarkers in patients treated with omalizumab, specifically in those with chronic urticaria and severe allergic asthma. As a secondary objective, various parameters in peripheral blood were analyzed to confirm their usefulness as follow-up biomarkers in patients receiving anti-IgE treatment. A retrospective study of both conditions was conducted, comparing cohorts under anti-IgE treatment (omalizumab), untreated patients, and a group of healthy controls. The aim was to analyze changes in T lymphocyte subpopulations and their relationship with the drug’s action. To this end, an exhaustive immunophenotyping was performed in whole blood by flow cytometry, including naïve, central memory, effector memory, and effector T lymphocytes, as well as Th1, Th2, and Th17 subtypes. Additionally, in patients with chronic urticaria, inflammation markers (ESR, D-dimer, CRP), atopy markers (prick test and total IgE levels), and autoimmunity markers (anti-thyroid antibodies and indirect basophil activation test) were evaluated. In patients with severe asthma, different spirometric parameters were analyzed to assess lung function (FEV1, FVC). The results showed that omalizumab induces a memory T lymphocyte profile, restores the balance between helper T-cell subpopulations, and contributes to the normalization of the different lymphocyte subsets. These findings support the hypothesis that monitoring these populations could be useful as biomarkers for diagnosis and for predicting treatment response in patients receiving anti-IgE therapy.

Date of Award	9 Mar 2026
Original language	Spanish
Supervisor	Aina Teniente Serra (Director) & Eva Maria Cabeza Martinez Caceres (Director)