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Table of Contents
Vol. 146, No. 3, 2008
Issue release date: June 2008
Int Arch Allergy Immunol 2008;146:248–254
(DOI:10.1159/000116361)

Basophil Sensitivity in Patients Not Responding to Venom Immunotherapy

Peternelj A. · Silar M. · Erzen R. · Kosnik M. · Korosec P.
University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia

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Abstract

Background: Treatment failure of venom immunotherapy (VIT) is not rare and the risk and pathogenic factors for those failures are so far poorly understood. For that reason we evaluated allergen-specific basophil sensitivity in patients who did not tolerate field re-stings after completed VIT treatment. Methods: Basophil responsiveness was evaluated by flow cytometry analyses of basophil CD63 surface expression induced by different concentrations of bee or wasp venom (1, 0.1 and 0.01 µg/ml) in 14 treated patients who had experienced systemic allergic reactions (Muller grades II–III) and 17 treated patients who had no reactions after the field re-stings. We also included a group of 28 Hymenoptera venom-allergic patients who had not received VIT. Results: In 14 patients who still reacted to bee or wasp sting, basophil response at a venom concentration of 0.1 µg/ml was significantly higher than in patients who tolerated field re-stings (p = 0.03; t test). Basophil response was also slightly higher at a concentration of 1 µg/ml, but not to statistical significance (p = 0.12; t test). There was no difference in the response to direct cross-linking of the IgE and in venom-specific IgE and IgG4 serum concentrations between those 2 groups (p > 0.8; Fisher’s exact test, t test). Patients who tolerated field re-stings have also significantly lower basophil response in comparison to patients who had not received VIT, both at 0.1 and 1 µg/ml of venom concentrations (p < 0.001; t test). Conclusions: The results suggest that basophil venom-specific sensitivity is associated with the efficiency of VIT.



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References

  1. Stokes JR, Casale TB: Allergy immunotherapy for primary care physicians. Am J Med 2006;119:820–823.
  2. Lerch E, Müller UR: Long-term protection after stopping venom immunotherapy: results of re-stings in 200 patients. J Allergy Clin Immunol 1998;101:606–612.
  3. Golden DBK, Kwiterovich KA, Kagey-Sobotka A, Valentine MD, Lichtenstein LM: Discontinuing venom immunotherapy: outcome after five years. J Allergy Clin Immunol 1996;97:579–587.
  4. van Halteren HK, van der Linden PWG, Burgers JA, Bartelink AKM: Discontinuation of yellow jacket venom immunotherapy: follow-up of 75 patients by means of deliberate sting challenge. J Allergy Clin Immunol 1997;100:767–770.
  5. Golden DBK, Kwiterovich KA, Kagey-Sobotka A, Lichtenstein LM: Discontinuing venom immunotherapy: extended observations. J Allergy Clin Immunol 1998;101:298–305.
  6. Golden DBK, Kagey-Sobotka A, Lichtenstein LM: Survey of patients after discontinuing venom immunotherapy. J Allergy Clin Immunol 2000;105:385–390.
  7. Lang R, Hawranek T: Hymenoptera venom immunotherapy and field stings. J Investig Allergol Clin Immunol 2006;16:224–231.
  8. Haugaard L, Nørregaard OF, Dahl R: In-hospital sting challenge in insect venom-allergic patients after stopping venom immunotherapy. J Allergy Clin Immunol 1991;87:699–702.
  9. Graft DF, Schoenwetter WF: Insect sting allergy: analysis of a cohort of patients who initiated venom immunotherapy from 1978 to 1986. Ann Allergy 1994;73:481–485.
  10. Rueff F, Przybilla B, Müller U, Mosbech H: Position paper: the sting challenge test in Hymenoptera venom allergy. Allergy 1996;51:216–225.
  11. Franken HH, Dubois AE, Minkema HJ, van der Heide S, de Monchy JG: Lack of reproducibility of a single negative sting challenge response in the assessment of anaphylactic risk in patients with suspected yellow jacket hypersensitivity. J Allergy Clin Immunol 1994;93:431–436.
  12. Knol EF, Mul FP, Jansen H, Calafat J, Roos D: Monitoring human basophil activation via CD63 monoclonal antibody 435. J Allergy Clin Immunol 1991;88:328–338.
  13. Sturm GJ, Bohm E, Trummer M, Weiglhofer I, Heinemann A, Aberer W: The CD63 basophil activation test in Hymenoptera venom allergy: a prospective study. Allergy 2004;59:1110–1117.
  14. Sainte-Laudy J, Sabbah A, Drouet M, Lauret MG, Loiry M: Diagnosis of venom allergy by flow cytometry: correlation with clinical history, skin tests, specific IgE, histamine and leukotriene C4 release. Clin Exp Allergy 2000;30:1166–1171.
  15. Erdmann SM, Sachs B, Kwiecien R, Moll-Slodowy S, Sauer I, Merk HF: The basophil activation test in wasp venom allergy: sensitivity, specificity and monitoring specific immunotherapy. Allergy 2004;59:1102–1109.
  16. Ebo DG, Sainte-Laudy J, Bridts CH, Mertens CH, Hagendorens MM, Schuerwegh AJ, De Clerck LS, Stevens WJ: Flow-assisted allergy diagnosis: current applications and future perspectives. Allergy 2006;61:1028–1039.
  17. Ebo DG, Hagendorens MM, Schuerwegh AJ, Beirens LM, Bridts CH, De Clerck LS, Stevens WJ: Flow-assisted quantification of in vitro activated basophils in the diagnosis of wasp venom allergy and follow-up of wasp venom immunotherapy. Cytometry B Clin Cytom 2006;72:196–203.
  18. Kosnik M, Silar M, Bajrovic N, Music E, Korosec P: High sensitivity of basophils predicts side-effects in venom immunotherapy. Allergy 2005;60:1401–1406.
  19. Kemp SF, Lockey RF: Anaphylaxis: a review of causes and mechanisms. J Allergy Clin Immunol 2002;110:341–348.
  20. Korosec P, Kosnik M: Predicting side-effects in venom immunotherapy by basophil activation: basophil sensitivity vs maximal response. Allergy 2007;62:81.
  21. MacGlashan D Jr: Releasability of human basophils: cellular sensitivity and maximal histamine release are independent variables. J Allergy Clin Immunol 1993;91:605–615.
  22. Light WC: Insect sting fatality 9 years after venom treatment (venom allergy, fatality). J Allergy Clin Immunol 2001;107:925.
  23. Golden DBK, Addison BI, Gadde J, Kagey-Sobotka A, Valentine MD, Lichtenstein LM: Prospective observations on patients who discontinue venom immunotherapy. J Allergy Clin Immunol 1989;84:162–167.
  24. Müller U, Helbling A, Bischof M: Predictive value of venomspecific IgE, IgG and IgG subclass antibodies in patients on immunotherapy with honey bee venom. Allergy 1989;44:412–418.


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