title: Monitoring honeybee venom immunotherapy in children with the basophil activation test.
abstract: BACKGROUND
  New in vitro methods are essential for developing better follow-up criteria for venom immunotherapy (VIT).
  
  
  METHODS
  Thirty-one children with a history of honeybee venom-induced systemic anaphylaxis were included in this prospective, single-blinded study. The basophil CD63 activation test (BAT) was assessed before starting VIT, at the end of the build-up phase (day 5), 6 months later, and after 2-4 yr of VIT.
  
  
  RESULTS
  Basophil CD63 activation test allowed identification of the culprit insect in 74% of honeybee venom-allergic children. In comparison, IgE reactivity was single positive in only 52% of children. Five days after starting VIT, BAT was highly comparable to before VIT. However, after 6 months and further after 2-4 yr of VIT, a significant and approximately fourfold decrease was demonstrated in CD63 response at sub-maximal 0.1 μg/ml allergen concentration, which mainly represents cellular sensitivity. No such differences were found at a higher 1 μg/ml of allergen concentration. Person-to-person analyses showed that after 2-4 yr of VIT, a marked CD63 decrease was evident in 85% of children. In addition, elevated basophil sensitivity measured before VIT was associated with the appearance of side effects observed during the build-up phase of VIT.
  
  
  CONCLUSIONS
  Basophil CD63 allergen-specific sensitivity seems to be a promising tool for monitoring protective immune response in honeybee VIT.
authors.affiliation: Department of Allergy, Rheumatology, and Clinical Immunology, Ljubljana University Children's Hospital, Ljubljana, Slovenia.
authors.forename: Simona E K
authors.initials: SE
authors.lastname: Žitnik
authors.forename: Tina
authors.initials: T
authors.lastname: Vesel
authors.forename: Tadej
authors.initials: T
authors.lastname: Avčin
authors.forename: Mira
authors.initials: M
authors.lastname: Šilar
authors.forename: Mitja
authors.initials: M
authors.lastname: Košnik
authors.forename: Peter
authors.initials: P
authors.lastname: Korošec
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D000818:Animals; D015549:Basophil Degranulation Test / Q000379:methods*; D001514:Bee Venoms / Q000009:adverse effects* / Q000276:immunology; D001516:Bees / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000276:immunology; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D001514:Bee Venoms