Title |
A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy
|
---|---|
Published in |
Clinical and Molecular Allergy, January 2018
|
DOI | 10.1186/s12948-017-0079-y |
Pubmed ID | |
Authors |
Marcello Albanesi, Andrea Nico, Alessandro Sinisi, Lucia Giliberti, Maria Pia Rossi, Margherita Rossini, Georgios Kourtis, Anna Simona Rucco, Filomena Loconte, Loredana Muolo, Marco Zurlo, Danilo Di Bona, Maria Filomena Caiaffa, Luigi Macchia |
Abstract |
Hymenoptera venom immunotherapy (VIT) is a clinically effective treatment. However, little is known about its long-term clinical efficacy and biological effects. Several mechanisms have been proposed to account for VIT efficacy, including reduction of specific IgE and induction of allergen-specific IgG4, but the overall picture remains elusive. We investigated Vespula VIT clinical efficacy up to 8 years after discontinuation and the kinetics of Vespula-specific IgE and IgG4. Out of 686 consecutive patients we retrospectively selected and analysed a series of 23 patients with Vespula allergy that underwent a 5-year IT course, followed by a prolonged follow-up. Clinical efficacy of VIT was assessed as number and severity of reactions to Vespula re-stinging events. The presence of Vespula-specific IgE and IgG4 was also monitored over time. During the VIT treatment, patients were protected, reporting no reactions or mild reactions in occasion of re-stinging events. This protection was entirely maintained during the follow-up, up to 8 years. Skin reactivity (reflecting mast cell-bound Vespula-specific IgE) and circulating Vespula-specific IgE levels declined substantially during VIT. Notably, this reduction was maintained over time during the follow-up. Moreover, all the patients were analysed for IgG4. A robust induction of Vespula-specific IgG4 was observed during the VIT course, with a substantial decline during the follow-up. We conclude that Vespula VIT is a clinically effective treatment, which induces long-term protection after discontinuation. The reduction of specific IgE, assessed by skin tests and RAST, closely matches the VIT- induced protection, while the IgG4 induction seems not to be associated with VIT clinical efficacy in the long term. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 19 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 4 | 21% |
Student > Ph. D. Student | 3 | 16% |
Student > Master | 2 | 11% |
Student > Bachelor | 2 | 11% |
Researcher | 2 | 11% |
Other | 2 | 11% |
Unknown | 4 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 7 | 37% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 16% |
Agricultural and Biological Sciences | 1 | 5% |
Business, Management and Accounting | 1 | 5% |
Psychology | 1 | 5% |
Other | 1 | 5% |
Unknown | 5 | 26% |