Possible dual role of anti-idiotypic antibodies in combined passive and active immunotherapy in honeybee sting allergy.
BACKGROUND
Passive infusion of beekeepers' plasma was shown to protect patients against systemic reactions occurring during active immunotherapy by mechanisms still to be clarified. It is tempting to speculate that anti-idiotypic antibodies could play a role because they are found in beekeepers' plasma and are involved in the regulation of IgE synthesis.


METHODS
In this report we studied the effects of passive infusion of a beekeeper's plasma rich in anti-idiotypic antibodies to a patient who experienced systemic reactions to honeybee venom.


RESULTS
We reported, during the days after the infusion, a decrease of clinical sensitivity to the honeybee venom. Indeed, the patient tolerated a cumulative dose of 280 micrograms of venom without adverse reactions. We also observed decreases in skin mast cell and in basophil sensitivity. After the plasma infusion, a modified rush immunotherapy with honeybee venom was initiated in our patient. In the following 76 weeks, increased levels of anti-idiotypic antibodies in the serum of the patient were associated with a diminution of specific antibodies (IgG and IgE) to honeybee venom.


CONCLUSIONS
These results suggest a dual role of anti-id in our combined protocol of passive and active immunotherapy: an immediate action on clinical sensitivity along with a decrease of skin mast cell and basophil sensitivity and an immunoregulatory role on specific antibody production.
Boutin
Y
Y
Centre de Recherche en Inflammation et Rhumatologie-Immunologie, Centre de Recherche du Centre Hospitalier de l'Université Laval, Laurier, Ste-Foy, Canada.
Jobin
M
M
Bédard
P M
PM
Hébert
M
M
Hébert
J
J
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood / Q000276:immunology* / Q000627:therapeutic use; D001514:Bee Venoms / Q000276:immunology*; D001667:Binding, Competitive; D005260:Female; D006636:Histamine Release; D006801:Humans; D007116:Immunization, Passive; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007299:Insect Bites and Stings / Q000276:immunology*; D012882:Skin Tests; D014611:Vaccination
D000888:Antibodies, Anti-Idiotypic; D001514:Bee Venoms; D007074:Immunoglobulin G; D007073:Immunoglobulin E