A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy
Posted on 2018-01-18 - 05:00
Abstract Background Hymenoptera venom immunotherapy (VIT) is a clinically effective treatment. However, little is known about its long-term clinical efficacy and biological effects. Several mechanisms have been proposed to account for VIT efficacy, including reduction of specific IgE and induction of allergen-specific IgG4, but the overall picture remains elusive. We investigated Vespula VIT clinical efficacy up to 8Â years after discontinuation and the kinetics of Vespula-specific IgE and IgG4. Out of 686 consecutive patients we retrospectively selected and analysed a series of 23 patients with Vespula allergy that underwent a 5-year IT course, followed by a prolonged follow-up. Methods Clinical efficacy of VIT was assessed as number and severity of reactions to Vespula re-stinging events. The presence of Vespula-specific IgE and IgG4 was also monitored over time. Results During the VIT treatment, patients were protected, reporting no reactions or mild reactions in occasion of re-stinging events. This protection was entirely maintained during the follow-up, up to 8Â years. Skin reactivity (reflecting mast cell-bound Vespula-specific IgE) and circulating Vespula-specific IgE levels declined substantially during VIT. Notably, this reduction was maintained over time during the follow-up. Moreover, all the patients were analysed for IgG4. A robust induction of Vespula-specific IgG4 was observed during the VIT course, with a substantial decline during the follow-up. Conclusions We conclude that Vespula VIT is a clinically effective treatment, which induces long-term protection after discontinuation. The reduction of specific IgE, assessed by skin tests and RAST, closely matches the VIT- induced protection, while the IgG4 induction seems not to be associated with VIT clinical efficacy in the long term.
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Albanesi, Marcello; Nico, Andrea; Sinisi, Alessandro; Giliberti, Lucia; Rossi, Maria; Rossini, Margherita; et al. (2018). A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.3980619.v1
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AUTHORS (14)
MA
Marcello Albanesi
AN
Andrea Nico
AS
Alessandro Sinisi
LG
Lucia Giliberti
MR
Maria Rossi
MR
Margherita Rossini
GK
Georgios Kourtis
AR
Anna Rucco
FL
Filomena Loconte
LM
Loredana Muolo
MZ
Marco Zurlo
DB
Danilo Bona
MC
Maria Caiaffa
LM
Luigi Macchia