Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Alerts
  • Advertising/recruitment
  • Subscribe
  • Contact
  • Current Issue
  • Past Issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Author's Takes
  • Reviews
    • View all reviews ...
    • 100th Anniversary of Insulin's Discovery (Jan 2021)
    • Hypoxia-inducible factors in disease pathophysiology and therapeutics (Oct 2020)
    • Latency in Infectious Disease (Jul 2020)
    • Immunotherapy in Hematological Cancers (Apr 2020)
    • Big Data's Future in Medicine (Feb 2020)
    • Mechanisms Underlying the Metabolic Syndrome (Oct 2019)
    • Reparative Immunology (Jul 2019)
    • View all review series ...
  • Viewpoint
  • Collections
    • Recently published
    • In-Press Preview
    • Commentaries
    • Concise Communication
    • Editorials
    • Viewpoint
    • Top read articles
  • Clinical Medicine
  • JCI This Month
    • Current issue
    • Past issues

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Author's Takes
  • Recently published
  • In-Press Preview
  • Commentaries
  • Concise Communication
  • Editorials
  • Viewpoint
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Alerts
  • Advertising/recruitment
  • Subscribe
  • Contact
The anti-IgE mAb omalizumab induces adverse reactions by engaging Fcγ receptors
Bianca Balbino, … , Pierre Bruhns, Laurent L. Reber
Bianca Balbino, … , Pierre Bruhns, Laurent L. Reber
Published November 26, 2019
Citation Information: J Clin Invest. 2020;130(3):1330-1335. https://doi.org/10.1172/JCI129697.
View: Text | PDF
Concise Communication Immunology Inflammation

The anti-IgE mAb omalizumab induces adverse reactions by engaging Fcγ receptors

  • Text
  • PDF
Abstract

Omalizumab is an anti-IgE monoclonal antibody (mAb) approved for the treatment of severe asthma and chronic spontaneous urticaria. Use of omalizumab is associated with reported side effects ranging from local skin inflammation at the injection site to systemic anaphylaxis. To date, the mechanisms through which omalizumab induces adverse reactions are still unknown. Here, we demonstrated that immune complexes formed between omalizumab and IgE can induce both skin inflammation and anaphylaxis through engagement of IgG receptors (FcγRs) in FcγR-humanized mice. We further developed an Fc-engineered mutant version of omalizumab, and demonstrated that this mAb is equally potent as omalizumab at blocking IgE-mediated allergic reactions, but does not induce FcγR-dependent adverse reactions. Overall, our data indicate that omalizumab can induce skin inflammation and anaphylaxis by engaging FcγRs, and demonstrate that Fc-engineered versions of the mAb could be used to reduce such adverse reactions.

Authors

Bianca Balbino, Pauline Herviou, Ophélie Godon, Julien Stackowicz, Odile Richard-Le Goff, Bruno Iannascoli, Delphine Sterlin, Sébastien Brûlé, Gael A. Millot, Faith M. Harris, Vera A. Voronina, Kari C. Nadeau, Lynn E. Macdonald, Andrew J. Murphy, Pierre Bruhns, Laurent L. Reber

×

Figure 2

Omalizumab/IgE ICs induce skin inflammation and anaphylaxis through engagement of FcγRs in FcγR-humanized mice.

Options: View larger image (or click on image) Download as PowerPoint
Omalizumab/IgE ICs induce skin inflammation and anaphylaxis through enga...
Representative bioluminescent images (A) and quantification (B) of MPO activity 2 hours after subcutaneous injection of IgE/omalizumab ICs in nude hFcγRKI mice (n = 9) or nude FcγRnull mice (n = 8). Regions of interest outlined in red in A surround sites of injection. Data in B are mean ± SEM pooled from 2 independent experiments. (C and D) Changes in body temperature (Δ°C [mean ± SEM]) after intravenous injection of IgE/omalizumab ICs into hFcγRKI mice (n = 13) or FcγRnull mice (n = 9) (C), or hFcγRKI mice (n = 9) or hFcγRKI C1q–/– mice (n = 8). Data are pooled from 3 (C) or 2 (D) independent experiments. *P < 0.05; ***P < 0.001 by contrast test in linear model (B and C) or ANOVA (D). For additional details on the statistical analysis, please refer to Supplemental Table 1.
Follow JCI:
Copyright © 2021 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts