Long-term IgG4 determinations in hymenoptera-sensitive treated patients.
Honey bee and vespid venom immunotherapy have been practiced for the past 10 years. Several studies have evaluated the short-term effects of this therapy. The current study evaluated the long-term effects using venom-specific IgG4 determinations. Forty-six patients ranging in age from 3 to 67 years were followed for periods up to 6 1/2 years. All patients included in the study demonstrated Hymenoptera sensitivity on intradermal testing using 0.2 mL of venom extract at concentrations of 0.01 microgram/mL, 0.1 microgram/mL, or 1 microgram/mL. IgE-specific venom antibody levels were tested and found to be elevated. During the first year following institution of venom immunotherapy, 46/46 patients demonstrated an increase in venom-specific IgG4. After the first year of treatment, values reached a plateau. The IgG4 venom-specific antibodies remained relatively constant over the second and third years of the study. Thirty of the 46 patients were followed for more than 3 years. All of the 30, treated greater than 3 years with continuous immunotherapy, demonstrated a gradual decline in IgG4 levels. Despite very low or negligible levels of venom-specific IgG4 antibodies, six patients accidentally stung were still clinically protected. This study suggests that long-term immunity is not mediated in the same manner as that of short-term protection.
Gentlesk
M J
MJ
Division of Allergy and Clinical Immunology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.
Halpern
G M
GM
Mansmann
H C
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000276:immunology / Q000628:therapy*; D000818:Animals; D001514:Bee Venoms / Q000276:immunology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006927:Hymenoptera; D007074:Immunoglobulin G / Q000032:analysis*; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012882:Skin Tests; D013997:Time Factors; D014862:Wasp Venoms / Q000276:immunology / Q000627:therapeutic use
D001514:Bee Venoms; D007074:Immunoglobulin G; D014862:Wasp Venoms