Increased Osteopontin Levels in Children Undergoing Venom Immunotherapy May Serve as a Marker of Clinical Efficacy

Abstract

Background: Venom immunotherapy (VIT) has its effect by modulating various mediators resulting in immune tolerance. The aim of this study was to measure changes in plasma osteopontin (OPN) and serum basal tryptase (sBT) levels over the course of 1 year of VIT in children with venom allergy. Methods: Children who suffered from a large local reaction (LLR) or a systemic reaction (SR) after insect stings were included along with control subjects. Measurements were performed before the initiation of VIT and 6 and 12 months after it had been started. Results: A total of 58 children (24 with SR, 18 with LLR and 16 control subjects) with a median age of 9.5 years (range 6.7-12.8) were enrolled. The plasma OPN levels of patients with LLR [median 1,477 ng/ml, interquartile range (IQR) 1,123-1,772] were significantly higher than patients with SR (882 ng/ml, 579-1,086; p < 0.001) and healthy control subjects (1,015 ng/ml, 815-1,203; p = 0.002). A significant increase in plasma OPN levels in children was determined after the 1-year VIT. The sBT levels of children with SR (4.1 ng/ml, 3.6-5.8) were significantly higher than children with LLR (3.1 ng/ml, 2.5-4.0) and control subjects (3.0 ng/ml, 2.9-3.8; p = 0.001). There was no significant change in the sBT levels of the patients after the 1-year VIT. Conclusions: The results of our study showed higher baseline levels of OPN in children with LLR compared to control subjects and children with SR. In children with SR, OPN levels were increased after the 1-year VIT. Our results may suggest a possible association between OPN and successful VIT in children.

Long-Term Follow-Up of Children after Venom Immunotherapy: Low Adherence to Anaphylaxis Guidelines

“…However, previous trials failed to show a predictive value of specific IgE antibody levels for the subsequent clinical course [11,16]. Recently, osteopontin has been suggested as a surrogate marker for successful VIT albeit further evaluation is required [21]. …”

Allergen-specific immunotherapy of Hymenoptera venom allergy – also a matter of diagnosis

“…Other changes during VIT include the increased expression of osteopontin on mRNA 119 and protein level in serum, 120 changes of miRNA expression (lower expression of miRNAs involved in allergic inflammation and higher expression of those involved in tolerance induction) during VIT up-dosing 121 and the decreased spontaneous release of prostaglandin E2 and an increase of lipoxin A4 at the beginning and a decrease after 6 months of therapy. 122 Non of the studied biomarkers were linked to clinical outcomes.…”

Quoi de neuf en allergologie pédiatrique en 2014 ? Épidémiologie générale, diagnostic (précoce), traitement, anaphylaxie, allergie alimentaire, médicamenteuse et aux venins et salives d’insectes (une revue de la littérature internationale 2014)

“…Dans la mesure où l'ostéospontine, une glycoprotéine connue pour ses effets à la fois pro-inflammatoires et immunorégulateurs, pourrait être impliquée dans les réactions allergiques et dans leur régulation, Yavuz et al ont effectué des dosages des concentrations basales de la tryptase et de l'ostéospontine dans le sérum de 58 enfants, dont 24 désensibilisés suite à des réactions systémiques plus ou moins graves lors de piqûres d'hyménoptères, 18 rapportant des réactions locales importantes et 16 enfants témoins, non allergiques aux venins d'hyménoptères [74]. Chez les enfants désensibilisés, les dosages ont été effectués avant le début de la DS, puis aux 6 e et 12 e mois de la DS.…”