title: A cutaneous allergen neutralisation test that correlates with the duration of venom immunotherapy.
abstract: BACKGROUND
  Despite the well-documented efficacy of Hymenoptera specific immunotherapy (SIT), there is no safe method to reliably characterise the patient level of protection. Only poor correlations between protection and allergen-specific serum immunoglobulins have been found, and a sting challenge is the only means to evaluate the efficacy of immunotherapy. Therefore, we aimed to develop a cutaneous test that measures in vivo neutralisation of the Hymenoptera venom.
  
  
  METHODS
  Twenty-four patients with wasp venom allergy were included in the study. Wasp-specific serum IgE, IgG and IgG4 were measured by ImmunoCAP. Dilutions of the individual patient sera were intradermally injected into the forearm. Then, wasp venom extract was injected into these sites to quantitatively assess the formation of wheals and flares.
  
  
  RESULTS
  The results show that during the course of SIT, patient sera gained the capacity to neutralise skin reactions to wasp venom extracts in vivo. The test correlated with the duration of SIT as well as with the concentration of IgG and IgG4.
  
  
  CONCLUSIONS
  The in vivo neutralisation test may become a promising tool in allergy diagnostics as well as in monitoring the success of SIT in patients undergoing allergen SIT.
authors.affiliation: Unit for Experimental Immunotherapy, Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Senti
authors.forename: Pål
authors.initials: P
authors.lastname: Johansen
authors.forename: Ruben
authors.initials: R
authors.lastname: Oliver
authors.forename: Bettina M
authors.initials: BM
authors.lastname: Prinz Vavricka
authors.forename: Nicole
authors.initials: N
authors.lastname: Graf
authors.forename: Brunello
authors.initials: B
authors.lastname: Wuthrich
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kundig
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood* / Q000145:classification; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D013997:Time Factors; D014862:Wasp Venoms / Q000276:immunology*
chemical_list: D000485:Allergens; D007074:Immunoglobulin G; D014862:Wasp Venoms; D007073:Immunoglobulin E