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A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy.

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 8 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 8 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.

SUBMITTER: Albanesi M

PROVIDER: S-EPMC5774115 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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A 13-year real-life study on efficacy, safety and biological effects of <i>Vespula</i> venom immunotherapy.

Albanesi Marcello M Nico Andrea A Sinisi Alessandro A Giliberti Lucia L Rossi Maria Pia MP Rossini Margherita M Kourtis Georgios G Rucco Anna Simona AS Loconte Filomena F Muolo Loredana L Zurlo Marco M Di Bona Danilo D Caiaffa Maria Filomena MF Macchia Luigi L

Clinical and molecular allergy : CMA 20180118

<h4>Background</h4><i>Hymenoptera</i> 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 IgG<sub>4</sub>, but the overall picture remains elusive. We investigated <i>Vespula</i> VIT clinical efficacy up to 8 years after discontinuation and the kinetics of <i>Vesp ...[more]

PMID: 29375272

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Dataset Information

A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy.

Publications

A 13-year real-life study on efficacy, safety and biological effects of <i>Vespula</i> venom immunotherapy.

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