title: Agreement of skin test with IL-4 production and CD40L expression by T cells upon immunotherapy of subjects with systemic reactions to Hymenoptera stings.
abstract: Venom immunotherapy is the only curative intervention for subjects with Hymenoptera venom allergy who suffering systemic reactions upon bee or wasp stings. Venom immunotherapy can restore normal immunity against venom allergens, as well as providing to allergic subjects a lifetime tolerance against venoms. Nevertheless, it is necessary using safety assays to monitoring the development of tolerance in the VIT protocols to avoid fatal anaphylactic reactions. The purpose of this study was to assess the modifications in several markers of tolerance induction in subjects with Hymenoptera venom allergy undergoing immunotherapy. The studies were performed at baseline time and after six month of VIT. Intradermal skin tests, basophil activation tests, specific IgE levels; and the T-cell markers (IL-4 and IFN-γ producing cells; and expression of the surface activation markers CD40L and CTLA-4) were assayed. At six month of immunotherapy all parameters studied had significant alterations. All decreased, except the IFN-γ producing cells. In addition, modifications in intradermal skin test showed a significant correlation with both, CD40L expression on CD4 T lymphocytes (p=0.043) and IL-4 producing T lymphocytes (p=0.012). Neither basophil activation test nor serum levels of sIgE demonstrated any correlation with the immunological parameters studied nor among them. These results suggest that both IL-4 production and CD40L expression could be two good indicators of the beneficial effects of venom immunotherapy which translate into skin tests.
authors.affiliation: Immunology Section, Hospital General Universitario de Ciudad Real, Spain; Medical Faculty of Ciudad Real, University of Castilla La Mancha, Spain. Electronic address: jmurra@sescam.jccm.es.
authors.forename: José M
authors.initials: JM
authors.lastname: Urra
authors.affiliation: Hematology Service, Hospital de Jerez (Cádiz), Spain.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Cabrera
authors.affiliation: Alergology Section, Hospital General Universitario de Ciudad Real, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Alfaya
authors.affiliation: Alergology Section, Hospital General Universitario de Ciudad Real, Spain; Medical Faculty of Ciudad Real, University of Castilla La Mancha, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Feo-Brito
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001514:Bee Venoms / Q000009:adverse effects / Q000276:immunology; D023201:CD40 Ligand / Q000096:biosynthesis* / Q000276:immunology; D002648:Child; D003888:Desensitization, Immunologic; D005260:Female; D005434:Flow Cytometry; D005455:Fluorescent Antibody Technique; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000276:immunology / Q000517:prevention & control*; D007299:Insect Bites and Stings / Q000276:immunology*; D015847:Interleukin-4 / Q000096:biosynthesis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012882:Skin Tests; D013601:T-Lymphocytes / Q000276:immunology*; D014862:Wasp Venoms / Q000009:adverse effects / Q000276:immunology
chemical_list: D001514:Bee Venoms; C508598:IL4 protein, human; D014862:Wasp Venoms; D023201:CD40 Ligand; D015847:Interleukin-4
keywords: Basophil activation test; CTLA-4; Hymenoptera venom allergy; IL-4; Intradermal skin test; Venom immunotherapy