Omalizumab is a recombinant DNA-derived humanised IgG1 kappa monoclonal antibody that binds with a higher affinity to free IgE and inhibits the binding of free IgE to high-affinity IgE receptor (FcεRI) expressed on mast cells and basophils. This results in the downregulation of FcεRI and decreased release of mediators of inflammatory response. Omalizumab neither binds directly to the high-affinity IgE receptor (FcεRI) nor the receptor-bound IgE. This monoclonal antibody was developed by Tanox, Novartis, and Genentech and received approval from the FDA in 2009 for the treatment of allergic asthma. Recently, it has been approved for the treatment of chronic spontaneous urticaria (CIU).
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