Basophil response and the induction of a tolerance in venom immunotherapy: a long‐term sting challenge study

Eržen, Renato; Košnik, Mitja; Šilar, Mira; Korošec, Peter

doi:10.1111/j.1398-9995.2012.02817.x

Cited by 73 publications

(86 citation statements)

References 41 publications

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“…123 The subclass of IgG antibodies is usually restricted to IgG1 and IgG4. 121 However, after stopping VIT, specific IgG starts to decrease 99,124,125 and patients appear to be protected by a mechanism independent from venom-specific IgG. 122 Taken together, available data do not support the use of specific IgE, specific IgG, or specific IgG subclasses or…”

Section: Specific Ige and Igg4 Levelsmentioning

confidence: 89%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

382

528

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Hymenoptera venom allergy is a potentially life‐threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic‐allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life‐threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1‐antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence‐based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta‐analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom‐allergic children and adults to prevent further moderate‐to‐severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence‐based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.

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Section: Specific Ige and Igg4 Levelsmentioning

confidence: 89%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

382

528

View full text Add to dashboard Cite

show abstract

“…A BAT was performed as previously described [3,5,6,7,8]. Briefly, whole blood was incubated with 0.1 or 1 µg/ml of honeybee or wasp venom (Hal Allergie, Leiden, The Netherlands) or with 0.55 µg/ml of anti-FcεRI monoclonal antibody (mAb; Bühlmann Laboratories, Schönenbuch, Switzerland), or with 2 µ M fMLP (Sigma, USA) as a control at 37°C for 15 min.…”

Section: Methodsmentioning

confidence: 99%

Clinical Routine Utility of Basophil Activation Testing for Diagnosis of Hymenoptera-Allergic Patients with Emphasis on Individuals with Negative Venom-Specific IgE Antibodies

Korošec¹,

Šilar²,

Eržen³

et al. 2013

Int Arch Allergy Immunol

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Background: Previous reports suggest the usefulness of basophil activation testing (BAT) in Hymenoptera-allergic patients with negative venom-specific IgE antibodies. We sought to evaluate the diagnostic utility of this testing in a routine clinical laboratory setting. Materials and Methods: Twenty-one patients with anaphylactic reactions to Hymenoptera sting (median grade III) and negative venom-specific IgE were routinely and prospectively tested with BAT. Results: We were able to diagnose 81% (17 of 21) of patients with BAT and 57% (12 of 21) with intradermal skin testing. Three wasp venom-allergic patients showed IgE positivity to rVes v 5. Four patients (19%) were negative for all tests. In the case of double-positive BAT, the culprit insect correlated with the venom that induced a significantly higher basophil response. Conclusions: BAT allows the identification of severe Hymenoptera-allergic patients with negative specific IgE and skin tests. The routine use of this cellular test should facilitate prescription of venom immunotherapy in complex cases with inconclusive diagnostic results.

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“…Although AIT reduces the allergic inflammation mediated by IgE-dependent mechanism over the time, a very early effect on basophil and mast cell activation status is observed just after the initiation of the therapeutic regimen, leading to a lower risk to develop anaphylactic manifestations [33][34][35]. The subjacent mechanism of basophil and mast cell desensitization has not been elucidated yet; however, some clues highlight this issue.…”

Section: Cellular and Molecular Mechanisms Of Aitmentioning

confidence: 93%

Allergen-Specific Immunotherapy Follow-Up by Measuring Allergen-Specific IgG as an Objective Parameter

Taketomi¹,

Miranda²,

Júnior³

et al. 2017

Immunotherapy - Myths, Reality, Ideas, Future

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The clinical efficacy of the allergen-specific immunotherapy (AIT) has been well-documented using inhalant or hymenoptera-derived allergens in atopic patients with corresponding specific IgE antibodies. AIT is considered as the unique treatment that is capable of modifying the natural course of the allergic disease because it induces a variety of immunological mechanisms, with emphasis in the production of blocking IgG antibodies by IL-10-stimulated B cells due to the generation of Treg, Breg, or even Th2 cells. Thus, the measurement of specific IgG subclasses, particularly IgG4, to the crude extract or more importantly to allergen components, might be a useful and potential tool to follow-up objectively the patients undergoing AIT in addition to clinical parameters. In this chapter, the authors have emphasized a very sensitive and highly specific reverse ELISA, developed by them, to measure IgG subclasses directed to clinically relevant natural allergens that are undoubtedly better when compared to those obtained with recombinant counterparts. Such a technique may produce more authentic results taking into account the IgG subclass binding capacity to a particular allergen and might be a valuable and alternative method for monitoring activation of tolerance-inducing mechanisms in patients under AIT.

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Basophil response and the induction of a tolerance in venom immunotherapy: a long‐term sting challenge study

Abstract: Our results suggest that the depression of allergen-specific basophil response seems to be associated with the induction of a tolerance after completing a course of VIT.

Cited by 73 publications

References 41 publications

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Clinical Routine Utility of Basophil Activation Testing for Diagnosis of Hymenoptera-Allergic Patients with Emphasis on Individuals with Negative Venom-Specific IgE Antibodies

Allergen-Specific Immunotherapy Follow-Up by Measuring Allergen-Specific IgG as an Objective Parameter

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