Key result
Omalizumab suppresses IgE-driven pathological myocardial remodeling and cardiac dysfunction via TGF-β signaling.
Why the study?
The molecular mechanisms linking immune factors, specifically IgE-FcεR1 signaling, to pathological cardiac remodeling and dysfunction remain unclear.
Omalizumab effects on remodeling remain hypothesis-generating; extends IgE associations to direct TGF-β mechanisms in models.
Cardiac remodeling is accompanied by cardiac hypertrophy, fibrosis, and dysfunction, eventually leading to heart failure (HF). However, the molecular mechanisms involved in cardiac remodeling are complicated, especially the association with immune. Immunoglobulin E (IgE) is a class of immunoglobulins involved in immune response to specific allergens. Recently, Zhao et al characterized a novel specific role of IgE and its high affinity receptor (FcεR1) in directly promoting pathological myocardial remodeling and cardiac dysfunction. Additionally, upon blocking IgE-FcεR1 signaling using FcεR1 genetic depletion or by administrating the anti-IgE monoclonal antibody omalizumab (Oma) in mice, they observed that cardiac hypertrophy and cardiac interstitial fibrosis induced by angiotensin II (Ang II) or transverse aortic constriction (TAC) were significantly suppressed. In contrast, IgE administration alone can aggravate pathological cardiac remodeling and dysfunction. RNA-seq and downstream analysis indicated that TGF-β was the common pathway and the most pivotal mediator in IgE-FcεR1-induced cardiac remodeling and dysfunction. Furthermore, the administration of a TGF-β inhibitor could ameliorate cardiac remodeling and improve cardiac function. Therefore, these findings suggest that IgE-FcεR1 maybe promising therapeutic targets for cardiac remodeling and provide an experimental basis for the use of omalizumab for HF patients combined with high serum IgE levels or allergic diseases.
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Cao et al. (2021) conducted an editorial in Cardiac remodeling and heart failure. IgE-FcεR1 signaling was evaluated. IgE and its high-affinity receptor FcεR1 directly promote pathological myocardial remodeling and cardiac dysfunction via the TGF-β signaling pathway, which can be suppressed by omalizumab.
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