Omalizumab for hypersensitive reaction to seminal plasma: A case report

Research progress of anti-IGE treatment for allergic rhinitis

BACKGROUND

Allergic rhinitis (AR) is an inflammatory reaction of the nasal mainly mediated by Immunoglobulin E(IgE). It is one of the most common chronic diseases in the world. Patients with nasal discomfort, persistent nasal itching, sneezing, runny nose and so on as the main symptoms, it is a refractory allergic disease, will seriously reduce the quality of life of patients.

OBJECTIVE

At present, the treatment of patients with allergic rhinitis is mainly to avoid contact with allergens, drug treatment and desensitization treatment. The serum IgE level of most patients is significantly increased. By introducing monoclonal antibodies into the gene-expression environment of IgE, the levels of free IgE can be effectively suppressed, resulting in a significant reduction in the incidence of AR. Therefore, this article will explore the mechanism and clinical application of this new anti-IgE drug, omalizumab.

CONCLUSION

Omalizumab can significantly relieve the condition of AR patients and reduce the dosage of corticosteroids and antihistamines, but its long-term efficacy and safety need further observation and analysis. Before use, the patient's status should be confirmed and the potential risks should be discussed with the patient in advance.

Seminal plasma hypersensitivity: A systematic review of clinical presentation, diagnostics, and management options

INTRODUCTION

Seminal plasma hypersensitivity (SPH) is a rare and often misdiagnosed condition characterized by local and/or systemic reactions to seminal plasma proteins following exposure to semen. We aimed to summarize key symptomatology, diagnostic features, and management options for SPH.

METHODS

The databases PubMed, EMBASE, Web of Science, Google Scholar, and Cochrane Review were searched with key words "seminal plasma hypersensitivity" and "seminal fluid allergy" through September 2023. Exclusion criteria included non-English articles, in vitro studies, publication before 1990, duplicates, and articles with no clinical relevance to SPH in women.

RESULTS

The search yielded 53 articles for review. Of these, 60.5% described systemic SPH and 39.5% described localized.

CONCLUSION

Diagnosis of SPH relies on a thorough patient history and confirmatory skin prick testing. The use of IgE assays is controversial and less accurate for cases of localized SPH. Knowledge of disease immunopathology, systemic versus localized symptom presentation, patient preference, and desire to conceive should guide management options. Artificial insemination has the potential for severe adverse reactions in systemic SPH so necessitates extra procedural precautions. SPH does not appear to impair fertility. Additional research on specific allergens implicated in SPH can aid in the development of more targeted immunotherapy approaches with improved safety and efficacy.

Biologics and anaphylaxis

PURPOSE OF REVIEW

The use of biologicals as therapeutic agents in oncology and other inflammatory diseases has dramatically increased during the last years. Due to their biological nature and inherent immunological activity, they are able to induce important adverse events, such as cytokine release reactions (rapid release of proinflammatory cytokines), serum sickness disease, and immediate or delayed hypersensitivity reactions, including anaphylaxis. The aim of the current article is to review the state of the art of anaphylaxis because of biological agents.

RECENT FINDINGS

Different phenotypes, and potential underlying endotypes, have been described in anaphylactic reactions to biologicals. There seems to be a spectrum from type 1 reactions (IgE or non-IgE-mediated) to cytokine release reactions, with some reactions falling in between both. Management should be directed according to such phenotypes.

SUMMARY

There is ongoing research to further define immediate adverse reactions to biologicals and to find relevant biomarkers to aid in their diagnosis. Such information will serve in defining their immediate and long term management.