CLINICAL CORRELATION OF THE VENOM-SPECIFIC IGG ANTIBODY LEVEL DURING MAINTENANCE VENOM IMMUNOTHERAPY

被引:65
作者
GOLDEN, DBK
LAWRENCE, ID
HAMILTON, RH
KAGEYSOBOTKA, A
VALENTINE, MD
LICHTENSTEIN, LM
机构
[1] Department of Medicine, Clinical Immunology Division, The Johns Hopkins University School of Medicine, Baltimore, MD
关键词
INSECT-STING ALLERGY; VENOM; ANAPHYLAXIS; IMMUNOTHERAPY; IGG ANTIBODIES; HYMENOPTERA;
D O I
10.1016/S0091-6749(05)80019-3
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Allergen immunotherapy is associated with a significant increase of specific IgG antibodies that have been suggested as a mechanism of action and as a marker of efficacy for immunotherapy. The value of venom-specific IgG antibody determinations as a measure of clinical protection against sting anaphylaxis has been difficult to prove in individual patients. We performed 211 insect sting challenges in 109 patients over a 4-year period to determine the significance of venom IgG levels 3 mug/ml or lower. Systemic symptoms occurred in only 1.6% of those with venom IgG more than 3 mug/ml, but in 16% of those with less than 3 mug/ml IgG, and notably in 26% of patients with low venom IgG who had received less than 4 years of treatment. The venom IgG level had no predictive value in patients who had received more than 4 years of therapy. Honeybee sting data were inconclusive because of the small number of subjects. We conclude that low venom-specific IgG levels are associated with an elevated risk of treatment failure during the first 4 years of immunotherapy with yellow jacket or mixed vespid venoms.
引用
收藏
页码:386 / 393
页数:8
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