High sensitivity of basophils predicts side-effects in venom immunotherapy.
BACKGROUND
Systemic side-effects of venom immunotherapy (VIT) represent a considerable problem in the treatment of patients allergic to Hymenoptera venom. We examined the hypothesis whether basophil responsiveness might be connected with the adverse reactions to VIT.


METHODS
Basophil surface expression of activation marker CD63 induced by different concentrations of honeybee and wasp venom (0.1 and 1 mug/ml) was measured by flow cytometry in 34 patients with history of systemic anaphylactic reactions to Hymenoptera sting just before rush honeybee or wasp VIT.


RESULTS
Eleven of 34 patients had systemic anaphylactic reaction (Mueller grades I-III) and one patient a large local reaction to VIT. In those 12 patients, median percentage of activated basophils after stimulation with VIT-specific venom in concentration of 0.1 microg/ml was 99% (range: 17-195) of value reached with stimulation with 1 microg/ml. Side-effects occurred in all patients with 0.1/1 ratios over 92% (eight of 12). In contrast, in 22 patients with no side-effects, the median 0.1/1 ratio was 25% (range: 2-92). These concentration-dependent activation ratios were significantly different between the groups with and without side reactions (P < 0.0001). We also show significant positive correlation of the occurrence/clinical grade of the side-effects with individual ratios of CD63 basophil response (r = 0.73, P < 0.0001).


CONCLUSIONS
The results suggest that increased basophil sensitivity to allergen-specific in vitro stimulation is significantly associated with major side-effects of VIT.
Kosnik
M
M
University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
Silar
M
M
Bajrovic
N
N
Music
E
E
Korosec
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000139:chemically induced / Q000517:prevention & control*; D000818:Animals; D015703:Antigens, CD / Q000032:analysis; D001491:Basophils / Q000276:immunology*; D001514:Bee Venoms / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D003876:Dermatitis, Atopic / Q000139:chemically induced / Q000517:prevention & control*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects*; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D010980:Platelet Membrane Glycoproteins / Q000032:analysis; D060149:Tetraspanin 30; D014862:Wasp Venoms / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use
D000485:Allergens; D015703:Antigens, CD; D001514:Bee Venoms; D015415:Biomarkers; C554586:CD63 protein, human; D010980:Platelet Membrane Glycoproteins; D060149:Tetraspanin 30; D014862:Wasp Venoms