IgE, IgG, IgG1 and IgG4 patterns in yellow jacket allergic patients during immunotherapy with a venom depot extract

Jeep, S.; Meysel, U.; Kunkel, G.

doi:10.1111/j.1365-2222.1992.tb03086.x

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…The efficacy of ultrarush therapy is therefore comparable with that of rush and slow conventional protocols. After the incremental phase and also during maintenance treatment, specific IgE levels changed to the same extent in the three treatment groups, in agreement with other studies [49, 50]. The ultrarush protocol significantly reduced total and specific IgE levels as the rush and conventional protocol does.…”

Section: Discussionsupporting

confidence: 91%

Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol

Florio

Giuliano²,

Oricchio³

et al. 2012

Journal of Allergy

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Background and Objective. Various venom immunotherapy (VIT) protocols are available for Hymenoptera allergy. Although adverse reactions (ADRs) to VIT are widely reported, controlled trials are still needed. We conducted a randomized prospective study to evaluate ADRs and the efficacy of three VIT regimens. Methods. 76 patients with Hymenoptera allergy, aged 16–76 years, were randomized to receive an ultrarush protocol (group A: 27 patients), a rush protocol (group B: 25), or a slow protocol (group C: 24). Aqueous venom extract was used in incremental phase and an adsorbed depot in maintenance phase. ADRs and accidental Hymenoptera stings during VIT were used to evaluate efficacy. Results. During incremental treatment, ADRs occurred in 1.99%, 3.7%, and 3.9% of patients in groups A, B, and C, and in 0.99%, 1.46%, and 2.7%, respectively, during maintenance. ADRs were significantly fewer in group A (incremental + maintenance phase) than in group C (1.29% versus 3.2%; P = 0.013). Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%). Conclusion. Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings. This study indicates that ultrarush VIT is a valid therapeutic option for Hymenoptera allergy.

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Section: Discussionsupporting

confidence: 91%

Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol

Florio

Giuliano²,

Oricchio³

et al. 2012

Journal of Allergy

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“…This indicates that a predominance of IgGl antibodies does not necessarily lead to a reduction in allergen-specific IgE. More detailed studies of antibody responses made by each patient to individual venom proteins, e.g., by immunoblotting methods (12), are required to give further information on this aspect of IgE regulation.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of IgG subclass antibodies in patients allergic to wasp or bee venom

Wilson

Deighton

Lachmann

et al. 1994

Allergy

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IgG1 and IgG4 antivenom antibody responses were compared in groups of patients who had experienced systemic reactions to wasp (Vespula spp.) or bee stings. Pretreatment serum IgG4 antibody levels were low in both groups, but IgG1 antibodies were significantly raised in bee-allergic patients (P < 0.002), probably reflecting their greater exposure to stings than wasp-reactive patients. No direct or indirect relationships were found, in untreated bee or wasp patients, between IgG1, IgG4, or IgE antibody levels and the severity of a patient's last systemic reaction to a sting. After a 12-week course of venom immunotherapy (VIT), IgG1 antibodies increased significantly only in wasp-sensitive patients (P < 0.001), although both groups responded with marked increases in venom-specific IgG4 (P < 0.01). Wasp-allergic subjects who responded to VIT with high production of specific IgG4 showed the greatest increases (pre- to post-VIT) in IgE antibodies (P < 0.05). This group also demonstrated a direct correlation (P < 0.05) between post-VIT levels of IgE and IgG1 antibodies, a finding contrary to an IgE-immunoregulatory role for IgG1. High levels of venom-specific IgG1 alone, or in combination with IgG4, were not protective in three patients who suffered repeated adverse reactions to bee VIT, showing that absolute levels of IgG subclass antivenom antibodies are not reliably indicative of clinical responsiveness in individual patients.

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“…4), while the specific IgE determined by the CAP System showed no significant differences. As has been shown for other allergens, IgE binding to an allergen extract is highly individual, as is the antibody response induced by IT (15)(16)(17)(18). It is well established that, up to a maximum…”

Section: Discussionmentioning

confidence: 96%

“…level, the amount of IgG antibody produced during IT is a function of the cumulative therapeutic dose given, and the induction of IgG antibody depends on the concentration of proteins present in the therapeutic extract (4,16). One may postulate that patients with a negative outcome of specific IT are more selectively sensitized to "minor allergens".…”

Section: Discussionmentioning

confidence: 99%

Honeybee venom allergy: immunoblot studies in allergic patients after immunotherapy and before sting challenge

Jeep

Paul

Müller

et al. 1996

Allergy

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By immunoblot techniques, detailed antibody studies were performed with sera of 20 honeybee-venom-allergic patients during or at the end of specific immunotherapy (median duration: 3 years) and before honeybee sting challenge. Before immunotherapy, all patients had experienced systemic allergic reactions to a honeybee sting, with a mean severity of 3.5 +/- 0.5 according to the Müller classification. After the sting challenge, 10 patients (reactors) reacted again with a systemic allergic reaction, whereas 10 patients (nonreactors) did not. No differences were observed between reactors and nonreactors in total serum IgE and specific IgE to honeybee venom at the time of challenge. For immunoblot, honeybee venom (RELESS) was separated on 7.5-20% SDS-PAGE. For detection of specific IgE, IgG, IgG1, IgG4, and IgM, an alkaline phosphatase-linked second antibody was used. Both groups showed 11 antibody-binding bands: at 52, 46, 40, 31, 18.7, 16.9, 13, 11, 10, 9, and 8 kDa; however, the antibody-binding pattern was individual. The reactors differed from nonreactors in showing intense IgE and less IgG4 binding to at least one single component of the venom extract. For nonreactors, the inverse relationship was observed. The hypothesis, "intensity of IgE > or = IgG4 leads to allergic symptoms", was highly significant (P = 0.00026; chi-square). These immunoblot findings could offer predictive value in distinguishing reactors from nonreactors.

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IgE, IgG, IgG1 and IgG4 patterns in yellow jacket allergic patients during immunotherapy with a venom depot extract

Cited by 10 publications

References 18 publications

Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol

Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol

A comparative study of IgG subclass antibodies in patients allergic to wasp or bee venom

Honeybee venom allergy: immunoblot studies in allergic patients after immunotherapy and before sting challenge

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