L Arzt1, D Bokanovic1, C Schrautzer1, K Laipold1, C Möbs2, W Pfützner2, S A Herzog3, J Vollmann4, N Reider5, B Bohle6, W Aberer1, G J Sturm1. 1. Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria. 2. Clinical & Experimental Allergology, Department of Dermatology and Allergology, Philipps-University of Marburg, Marburg, Germany. 3. Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria. 4. Institute of Zoology, University of Graz, Graz, Austria. 5. Department of Dermatology, Venerology and Allergology, Medical University of Innsbruck, Innsbruck, Austria. 6. Division of Cellular Allergology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
Abstract
BACKGROUND: Currently available tests are unable to distinguish between asymptomatic sensitization and clinically relevant Hymenoptera venom allergy. A reliable serological marker to monitor venom immunotherapy (VIT) does also not exist. Our aim was to find reliable serological markers to predict tolerance to bee and vespid stings. METHODS: We included 77 asymptomatically sensitized subjects, 85 allergic patients with acute systemic sting reactions, and 61 allergic patients currently treated with VIT. Levels of sIgE and sIgG4 to bee and vespid venom, rApi m 1, and rVes v 5 were measured immediately after allergic sting reactions or before sting challenges and 4 weeks later. All sting challenges were tolerated. The inhibitory activity was determined using BAT inhibition and ELIFAB assay. RESULTS: Median sIgG4 levels were 96-fold higher in VIT patients (P < .001) while sIgE/sIgG4 ratios were consistently lower (P < .001). The ELIFAB assay was paralleled by low sIgE/sIgG4 ratios in VIT patients, showing markedly higher allergen-blocking capacity (P < .001). An almost complete inhibition of the basophil response was seen in all patients treated with vespid venom, but not in those treated with bee venom. Four weeks after the sting, sIgE and sIgG4 levels were increased in allergic and asymptomatically sensitized patients, but not in VIT patients. CONCLUSION: Immunological responses after stings varied in bee and vespid venom-allergic patients. In patients under VIT, sIgE and sIgG4 remained completely stable after sting challenges. Monitoring VIT efficacy was only possible in vespid venom allergy, and the sIgG4 threshold for rVes v 5 had the highest sensitivity to confirm tolerance. The BAT inhibition test was the most reliable tool to confirm tolerance on an individual basis.
BACKGROUND: Currently available tests are unable to distinguish between asymptomatic sensitization and clinically relevant Hymenoptera venom allergy. A reliable serological marker to monitor venom immunotherapy (VIT) does also not exist. Our aim was to find reliable serological markers to predict tolerance to bee and vespid stings. METHODS: We included 77 asymptomatically sensitized subjects, 85 allergicpatients with acute systemic sting reactions, and 61 allergicpatients currently treated with VIT. Levels of sIgE and sIgG4 to bee and vespid venom, rApi m 1, and rVes v 5 were measured immediately after allergic sting reactions or before sting challenges and 4 weeks later. All sting challenges were tolerated. The inhibitory activity was determined using BAT inhibition and ELIFAB assay. RESULTS: Median sIgG4 levels were 96-fold higher in VITpatients (P < .001) while sIgE/sIgG4 ratios were consistently lower (P < .001). The ELIFAB assay was paralleled by low sIgE/sIgG4 ratios in VITpatients, showing markedly higher allergen-blocking capacity (P < .001). An almost complete inhibition of the basophil response was seen in all patients treated with vespid venom, but not in those treated with bee venom. Four weeks after the sting, sIgE and sIgG4 levels were increased in allergic and asymptomatically sensitized patients, but not in VITpatients. CONCLUSION: Immunological responses after stings varied in bee and vespid venom-allergicpatients. In patients under VIT, sIgE and sIgG4 remained completely stable after sting challenges. Monitoring VIT efficacy was only possible in vespid venom allergy, and the sIgG4 threshold for rVes v 5 had the highest sensitivity to confirm tolerance. The BAT inhibition test was the most reliable tool to confirm tolerance on an individual basis.
Authors: Pia Gattinger; Christian Lupinek; Lampros Kalogiros; Mira Silar; Mihaela Zidarn; Peter Korosec; Christine Koessler; Natalija Novak; Rudolf Valenta; Irene Mittermann Journal: PLoS One Date: 2018-06-25 Impact factor: 3.240
Authors: Julia Eckl-Dorna; Sergio Villazala-Merino; Birgit Linhart; Alexander V Karaulov; Yury Zhernov; Musa Khaitov; Verena Niederberger-Leppin; Rudolf Valenta Journal: Front Immunol Date: 2019-01-17 Impact factor: 7.561
Authors: Patrik Tripolt; Lisa Arzt-Gradwohl; Urban Čerpes; Karin Laipold; Barbara Binder; Gunter Johannes Sturm Journal: PLoS One Date: 2020-04-16 Impact factor: 3.240
Authors: Joanna Matysiak; Eliza Matuszewska; Marek L Kowalski; Sławomir W Kosiński; Ewa Smorawska-Sabanty; Jan Matysiak Journal: Vaccines (Basel) Date: 2021-03-12