title: Wasp venom rush immunotherapy induces transient downregulation of B cell surface molecule expression.
abstract: BACKGROUND
  Little is known about the involvement of B cells in venom immunotherapy (VIT). To elucidate changes in the B cell phenotype during this process, we examined the expression of several surface molecules on peripheral B cells before and during VIT.
  
  
  METHODS
  15 venom-allergic patients with a history of systemic reactions after a wasp sting and venom-specific skin test reactivity as well as serum IgE were investigated before VIT (day 1), 1 day after reaching a maintenance dose of 100 microg (day 6) during inpatient rush VIT, and again on day 26 during continued outpatient maintenance therapy. Changes in the serum levels of total IgE, allergen-specific IgE (sIgE) and sIgG4 were measured by ELISA. Expression of several surface molecules on double-labelled B cells was studied by flow cytometry of peripheral blood mononuclear cells.
  
  
  RESULTS
  Levels of total IgE, sIgE and sIgG4 showed a significant increase after 26 days of VIT. On day 6, cell surface expression of HLA- II-DR, CD5, CD32 and CD54 was decreased in intensity and numbers of positive cells compared to day 1, while on day 26, expression of these molecules approached again baseline levels. Furthermore, a trend to decreased CD23 was noted on day 6. No changes were observed for CD40, CD86, CD95 and HLA-I-ABC.
  
  
  CONCLUSIONS
  These data show that during initiation of rush VIT, B cell expression of surface molecules involved in T-B cell cooperation and antigen presentation is downmodulated. B cells may thus be additional direct or indirect targets of high-dose antigen therapy and contribute to the persistence of TH1 responses during maintenance VIT treatment.
authors.affiliation: Department of Dermatology and Allergy, Charité Campus Mitte, Humboldt University, Berlin, Germany.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Roever
authors.forename: Beate M
authors.initials: BM
authors.lastname: Henz
authors.forename: Margitta
authors.initials: M
authors.lastname: Worm
mesh_terms: D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D000944:Antigens, Differentiation, B-Lymphocyte / Q000378:metabolism*; D001402:B-Lymphocytes / Q000276:immunology*; D003888:Desensitization, Immunologic; D015536:Down-Regulation; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology / Q000628:therapy*; D007073:Immunoglobulin E / Q000096:biosynthesis; D007074:Immunoglobulin G / Q000096:biosynthesis; D007700:Kinetics; D008875:Middle Aged; D014862:Wasp Venoms / Q000276:immunology / Q000627:therapeutic use*
chemical_list: D015703:Antigens, CD; D000944:Antigens, Differentiation, B-Lymphocyte; D006684:HLA-DR Antigens; D007074:Immunoglobulin G; D014862:Wasp Venoms; D007073:Immunoglobulin E