Good news for the approximately five million asthma patients in this country from this week’s congress in Munich of the European Respiratory Society: Japanese scientists have demonstrated that kissing for half an hour, and presumably other forms of sexual foreplay, has a statistically proven effect on the levels of IgE.

IgE is the antibody that is responsible for triggering the release of chemicals within the body that produces the misery-making symptoms of asthma and allergic rhinitis (runny noses). IgE is therefore a favoured target for any treatment for allergic diseases. Although an excess of IgE may bring on the typical symptoms of asthma, shortness of breath, wheezing and coughing, the scientific effect of a long kiss on IgE levels, and hence asthma attacks, may be medically interesting but its therapeutic value is likely to be limited.

Changing IgE levels is not the primary aim of kissing. Not so with a new drug, Xolair (omalizumab). Xolair is a preparation that specifically targets at the cells that respond to allergens, the substances in the atmosphere that cause an allergic reaction in patients who are sensitive to them, and in consequence an increase in IgE levels circulating in the blood.

Ninety per cent of patients who suffer asthmatic symptoms do so because of an allergy and react because of the increased levels of IgE. Asthma hasn’t a single cause, or even a single group of causes, for there are another 10 per cent of cases that can be shown not to suffer from the result of exposure to an allergen that has set off an IgE-mediated response. Their intolerance to other environmental factors is not a true allergy: these substances may range from aspirin to cleaning fluids, and even high-quality, expensive perfumes as well as atmospheric pollution or cigarette smoke. These patients don’t have an increase in IgE levels in the blood, the hall-mark of an allergy, and won’t be helped by Xolair.

The good news about Xolair, and even in a minor way kissing, will go some way to compensate for the worrying, but wise, warning that was published recently in the Journal of the Royal Society of Medicine. This warning had already been emphasised during the past few years in the British Thoracic Society guidelines — that long-acting beta-agonist drugs, even in inhalers, used alone were potentially dangerous. However, even with the best available treatment with long-acting inhaled steroids and long-acting beta agonists used in combination, 20 per cent of asthma patients, who have high IgE levels and an obvious allergic response still suffer the devastating effects of asthma.

The advent of Xolair — which still has to receive official approval and obtain the necessary licences — offers hope for the first time to the breathless, wheezing, coughing unfortunate 20 per cent, who, although taking their combination steroid/long-acting beta-agonist therapy, still suffer severe, life-threatening attacks. Their symptoms are not even controlled when they add to the treatment lifestyle changes such as avoiding allergens.

Scientists working for Novartis have argued that the only way of improving life for this 20 per cent of poor responders to accepted treatment is to deal with the IgE at source. The excess of IgE, triggered by the presence of the allergen, flows through the bloodstream and attaches itself to inflammatory cells (mast cells) in the nose, breathing passages, skin and gut, so that when there is another exposure to the allergen, the IgE induces an aggressive response of the immune system to what in other people would be a totally innocuous substance.

The mast cells break down and release such chemicals as histamine into the bloodstream and it is there that histamine-like substances cause the allergic reaction. Xolair targets the IgE antibodies, attaches itself to them and prevents them from locking into the mast cells whose disintegration they will later help to achieve. If the IgE can be prevented from binding to the mast cells, the damaging allergens will no longer have such an effect on the patient, the number and severity of the attack will be dramatically reduced and patients will again, or sometimes for the first time in adult life, be able to lead a normal social and professional life.

Xolair is an add-on treatment. It doesn’t replace inhaled corticosteroids combined with long-acting beta agonists, but is taken as well as them. It is given as an injection regularly once a month or, less often, once a fortnight. The injection is a simple one — a subcutaneous prick, not a jab thrust into a muscle nor an intravenous injection. It appears to be side-effect friendly. It is expensive but, for the 20 per cent of patients with asthma who are inadequately controlled, it is likely to be lifesaving.

It will allow them to sleep well, speak and walk without frightening breathlessness, will remove their anxiety, and may even enable an asthma sufferer to have enough breath to experience the advantages of the Japanese asthma treatment of kissing.